Provider Demographics
NPI:1790007904
Name:OAK BROOK HOME HEALTH LLC
Entity Type:Organization
Organization Name:OAK BROOK HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:PACAL
Authorized Official - Last Name:ALEGRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:630-279-2650
Mailing Address - Street 1:260 WOOD GLEN LN
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1535
Mailing Address - Country:US
Mailing Address - Phone:630-279-2650
Mailing Address - Fax:630-279-2679
Practice Address - Street 1:260 WOOD GLEN LN
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1535
Practice Address - Country:US
Practice Address - Phone:630-279-2650
Practice Address - Fax:630-279-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health