Provider Demographics
NPI:1790438976
Name:ULTIMATE INDEPENDENCE LLC
Entity Type:Organization
Organization Name:ULTIMATE INDEPENDENCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-782-6484
Mailing Address - Street 1:15100 S INDIAN BOUNDARY LINE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-7529
Mailing Address - Country:US
Mailing Address - Phone:815-782-6484
Mailing Address - Fax:815-230-5028
Practice Address - Street 1:15100 S INDIAN BOUNDARY LINE RD STE 2
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-7529
Practice Address - Country:US
Practice Address - Phone:815-782-6484
Practice Address - Fax:815-230-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies