Provider Demographics
NPI:1588630990
Name:PREMIER HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:PREMIER HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REMEDIOS
Authorized Official - Middle Name:T
Authorized Official - Last Name:BADAR
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:773-586-6717
Mailing Address - Street 1:6233 W 63RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-5009
Mailing Address - Country:US
Mailing Address - Phone:773-586-6717
Mailing Address - Fax:773-586-6716
Practice Address - Street 1:6233 W 63RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-5009
Practice Address - Country:US
Practice Address - Phone:773-586-6717
Practice Address - Fax:773-586-6716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010113251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147698Medicare ID - Type UnspecifiedHOME HEALTH CARE