Provider Demographics
NPI:1508885930
Name:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Other - Org Name:FRANCISCAN HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:A
Authorized Official - Last Name:BANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-756-1000
Mailing Address - Street 1:1400 OTTO BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-3871
Mailing Address - Country:US
Mailing Address - Phone:708-709-2030
Mailing Address - Fax:708-709-2027
Practice Address - Street 1:1400 OTTO BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3871
Practice Address - Country:US
Practice Address - Phone:708-709-2030
Practice Address - Fax:708-709-2027
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-18
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1001080251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9728OtherBLUE CROSS/BLUE SHIELD
IL147267Medicare ID - Type UnspecifiedHOME HEALTH AGENCY
IL=========003Medicaid