Provider Demographics
NPI:1457667305
Name:COMPLETE HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:COMPLETE HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY SUPERVISOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:LILY
Authorized Official - Middle Name:
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-814-1672
Mailing Address - Street 1:2800 S WENTWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4766
Mailing Address - Country:US
Mailing Address - Phone:773-814-1672
Mailing Address - Fax:312-808-1288
Practice Address - Street 1:2800 S WENTWORTH AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-4766
Practice Address - Country:US
Practice Address - Phone:773-814-1672
Practice Address - Fax:312-808-1288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-28
Last Update Date:2010-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011213251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1011213OtherSTATE LICENSE