Provider Demographics
NPI:1598732075
Name:EHS HOME HEALTH CARE SERVICE INC
Entity Type:Organization
Organization Name:EHS HOME HEALTH CARE SERVICE INC
Other - Org Name:ADVOCATE HOME HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SVP REGION CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-299-1610
Mailing Address - Street 1:2311 W 22ND ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1225
Mailing Address - Country:US
Mailing Address - Phone:630-572-1232
Mailing Address - Fax:630-368-5912
Practice Address - Street 1:2311 W 22ND ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1225
Practice Address - Country:US
Practice Address - Phone:630-572-1232
Practice Address - Fax:630-368-5912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-03
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1001031251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9665OtherBLUE CROSS BLUE SHIELD
IL9665OtherBLUE CROSS BLUE SHIELD
IL=========002Medicaid