Provider Demographics
NPI:1578114716
Name:VISITING NURSES OF ILLINOIS, INC.
Entity Type:Organization
Organization Name:VISITING NURSES OF ILLINOIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BALAJOJI
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:THANUGUNDLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-728-6820
Mailing Address - Street 1:5901 N CICERO AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5715
Mailing Address - Country:US
Mailing Address - Phone:773-728-6820
Mailing Address - Fax:773-672-8895
Practice Address - Street 1:5901 N CICERO AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5715
Practice Address - Country:US
Practice Address - Phone:773-728-6820
Practice Address - Fax:773-672-8895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health