Provider Demographics
NPI:1497923254
Name:ELMHURST MEMORIAL HOME HEALTH
Entity Type:Organization
Organization Name:ELMHURST MEMORIAL HOME HEALTH
Other - Org Name:ACTION MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-833-8200
Mailing Address - Street 1:855 N CHURCH CT
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1036
Mailing Address - Country:US
Mailing Address - Phone:630-833-8200
Mailing Address - Fax:630-833-9926
Practice Address - Street 1:701 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-3368
Practice Address - Country:US
Practice Address - Phone:630-652-1807
Practice Address - Fax:630-932-5523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000520332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232463OtherBLUE CROSS
IL02232463OtherBLUE CROSS
IL4818280002Medicare NSC