Provider Demographics
NPI:1447204516
Name:TENDER LOVING CARE HEALTH CARE SERVICES OF ILLINOIS, LLC
Entity Type:Organization
Organization Name:TENDER LOVING CARE HEALTH CARE SERVICES OF ILLINOIS, LLC
Other - Org Name:AMEDISYS HOME HEALTH OF ILLINOIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-292-2031
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-292-2031
Mailing Address - Fax:225-295-9678
Practice Address - Street 1:680 N LAKE SHORE DR
Practice Address - Street 2:STE 920
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4546
Practice Address - Country:US
Practice Address - Phone:312-573-0685
Practice Address - Fax:312-573-0698
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TLC HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-21
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010533251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL306348200OtherUS DEPT OF LABOR
IL1025113OtherIL UNITED HEALTHCARE CONT
IL147475OtherILLINOIS UNICARE
IL50408OtherILLINOIS BC BS CONTRACT
IL306348200OtherUS DEPT OF LABOR