Provider Demographics
NPI:1508142845
Name:SMITH THOMAS-WILLIAMS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:SMITH THOMAS-WILLIAMS HEALTHCARE, LLC
Other - Org Name:STW HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-957-2000
Mailing Address - Street 1:17500 E CARRIAGEWAY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2057
Mailing Address - Country:US
Mailing Address - Phone:708-957-2000
Mailing Address - Fax:708-957-3649
Practice Address - Street 1:17500 E CARRIAGEWAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2057
Practice Address - Country:US
Practice Address - Phone:708-957-2000
Practice Address - Fax:708-957-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2011-N1130251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health