Provider Demographics
NPI:1659356483
Name:INDEPENDENCE PLUS, INC.
Entity Type:Organization
Organization Name:INDEPENDENCE PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:
Authorized Official - Last Name:COITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-366-7696
Mailing Address - Street 1:800 JORIE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-2252
Mailing Address - Country:US
Mailing Address - Phone:800-366-7696
Mailing Address - Fax:630-954-0091
Practice Address - Street 1:800 JORIE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-2252
Practice Address - Country:US
Practice Address - Phone:708-366-4500
Practice Address - Fax:708-366-4553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1004472251E00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9899OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
IL9899OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
IL========= 0002OtherCIGNA HEALTHCARE
IL=========-002Medicaid