Provider Demographics
NPI:1740230622
Name:CLASSIC HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:CLASSIC HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSALYN
Authorized Official - Middle Name:SANCHEZ
Authorized Official - Last Name:MAGSINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-620-9251
Mailing Address - Street 1:2200 S MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5334
Mailing Address - Country:US
Mailing Address - Phone:630-620-9251
Mailing Address - Fax:630-620-9254
Practice Address - Street 1:2200 S MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5334
Practice Address - Country:US
Practice Address - Phone:630-620-9251
Practice Address - Fax:630-620-9254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010558251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147901Medicare Oscar/Certification