Provider Demographics
NPI:1588004436
Name:ADDUS HEALTHCARE, INC
Entity Type:Organization
Organization Name:ADDUS HEALTHCARE, INC
Other - Org Name:ADDUS EVERGREEN CLUB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NATIONAL CONTRACTS
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMARICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS, MBA
Authorized Official - Phone:630-296-3400
Mailing Address - Street 1:2300 WARRENVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1765
Mailing Address - Country:US
Mailing Address - Phone:630-296-3400
Mailing Address - Fax:630-487-2713
Practice Address - Street 1:2929 BROADWAY ST
Practice Address - Street 2:SUITE 7A
Practice Address - City:MOUNT VERNON
Practice Address - State:IL
Practice Address - Zip Code:62864-2383
Practice Address - Country:US
Practice Address - Phone:618-244-4481
Practice Address - Fax:618-244-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-25
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care