Provider Demographics
NPI:1851419915
Name:HOME HEALTH PROVIDERS PC
Entity Type:Organization
Organization Name:HOME HEALTH PROVIDERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-444-2300
Mailing Address - Street 1:4507 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2621
Mailing Address - Country:US
Mailing Address - Phone:708-444-2300
Mailing Address - Fax:
Practice Address - Street 1:4507 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2621
Practice Address - Country:US
Practice Address - Phone:708-444-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147886Medicare ID - Type Unspecified