Provider Demographics
NPI:1720039373
Name:QUALITY HOME CARE SERVICES LTD
Entity Type:Organization
Organization Name:QUALITY HOME CARE SERVICES LTD
Other - Org Name:QUALITY HOME CARE LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDYARD
Authorized Official - Middle Name:U
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-471-0890
Mailing Address - Street 1:3510 W 79TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-1430
Mailing Address - Country:US
Mailing Address - Phone:773-471-0890
Mailing Address - Fax:773-471-0280
Practice Address - Street 1:3510 W 79TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1430
Practice Address - Country:US
Practice Address - Phone:773-471-0890
Practice Address - Fax:773-471-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1007038251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9951OtherBLUE CROSS
IL1007038OtherLICENSE NUMBER
IL=========OtherFEIN
IL9951OtherBLUE CROSS
IL=========OtherFEIN