Provider Demographics
NPI:1851351233
Name:RESIDENTIAL HOME HEALTH ILLINOIS, LLC
Entity Type:Organization
Organization Name:RESIDENTIAL HOME HEALTH ILLINOIS, LLC
Other - Org Name:RESIDENTIAL HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-524-6401
Mailing Address - Street 1:5440 CORPORATE DRIVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098
Mailing Address - Country:US
Mailing Address - Phone:866-902-4000
Mailing Address - Fax:866-903-4000
Practice Address - Street 1:1431 OPUS PLACE
Practice Address - Street 2:SUITE 310
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515
Practice Address - Country:US
Practice Address - Phone:866-902-4000
Practice Address - Fax:866-903-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1006758251E00000X
IL1011738251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9875OtherBLUE CROSS
IL36396225301Medicaid
IL36396225301Medicaid