Provider Demographics
NPI:1598947418
Name:INGALLS HOME CARE
Entity Type:Organization
Organization Name:INGALLS HOME CARE
Other - Org Name:INGALLS PRIVATE DUTY HOME NURSING AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASST DIRECTOR QUALITY & COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIKSIK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-331-0226
Mailing Address - Street 1:1 INGALLS DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:IL
Mailing Address - Zip Code:60426-3558
Mailing Address - Country:US
Mailing Address - Phone:708-331-0226
Mailing Address - Fax:708-915-2749
Practice Address - Street 1:1 INGALLS DR
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:IL
Practice Address - Zip Code:60426-3558
Practice Address - Country:US
Practice Address - Phone:708-331-0226
Practice Address - Fax:708-915-2749
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INGALLS HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1636254OtherBLUE CROSS