Provider Demographics
NPI:1518065234
Name:PREFERRED HOME HEALTHCARE PROVIDERS SC
Entity Type:Organization
Organization Name:PREFERRED HOME HEALTHCARE PROVIDERS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:SHEHATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-722-4277
Mailing Address - Street 1:300 N OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432
Mailing Address - Country:US
Mailing Address - Phone:815-722-4277
Mailing Address - Fax:815-722-4288
Practice Address - Street 1:300 N OTTAWA ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432
Practice Address - Country:US
Practice Address - Phone:815-722-4277
Practice Address - Fax:815-722-4288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010506251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health