Provider Demographics
NPI:1558850230
Name:IMPERIAL HOMECARE SOLUTIONS LLC
Entity Type:Organization
Organization Name:IMPERIAL HOMECARE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GERALD CARLO
Authorized Official - Middle Name:C
Authorized Official - Last Name:IMPERIAL
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:773-934-4219
Mailing Address - Street 1:2720 WESTWOOD DR APT 3D
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-4951
Mailing Address - Country:US
Mailing Address - Phone:773-934-4219
Mailing Address - Fax:
Practice Address - Street 1:2720 WESTWOOD DR APT 3D
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-4951
Practice Address - Country:US
Practice Address - Phone:773-934-4219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health