Provider Demographics
NPI:1841389236
Name:DIRECT HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:DIRECT HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWOKENKWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-777-9271
Mailing Address - Street 1:4001 W DEVON AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4523
Mailing Address - Country:US
Mailing Address - Phone:773-777-9271
Mailing Address - Fax:
Practice Address - Street 1:4001 W DEVON AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4523
Practice Address - Country:US
Practice Address - Phone:773-777-9271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010414251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147847Medicare ID - Type Unspecified