Provider Demographics
NPI:1518581461
Name:MERCY REIGNS HOMECARE SERVICES LTD.
Entity Type:Organization
Organization Name:MERCY REIGNS HOMECARE SERVICES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVO
Authorized Official - Middle Name:EWANG
Authorized Official - Last Name:EWANE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA RN
Authorized Official - Phone:630-430-6118
Mailing Address - Street 1:3116 PRAIRIE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-9229
Mailing Address - Country:US
Mailing Address - Phone:630-566-9165
Mailing Address - Fax:
Practice Address - Street 1:3116 PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-9229
Practice Address - Country:US
Practice Address - Phone:630-566-9165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3001825OtherDPH