Provider Demographics
NPI:1790778348
Name:METROPOLITAN HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:METROPOLITAN HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SECRETARY/DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:RENATO
Authorized Official - Middle Name:SOTELO
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-568-1033
Mailing Address - Street 1:662 WAUKEGAN RD
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4348
Mailing Address - Country:US
Mailing Address - Phone:847-568-1033
Mailing Address - Fax:847-568-1034
Practice Address - Street 1:662 WAUKEGAN RD
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4348
Practice Address - Country:US
Practice Address - Phone:847-568-1033
Practice Address - Fax:847-568-1034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-30
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010319251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D1021895OtherCLIA
IL1010319OtherIDPH
IL1010319OtherIDPH
IL1010319OtherIDPH