Provider Demographics
NPI:1851439079
Name:UNITED HOME CARE INCORPORATED OF ILLINOIS
Entity Type:Organization
Organization Name:UNITED HOME CARE INCORPORATED OF ILLINOIS
Other - Org Name:UNITED HOME CARE INC OF ILLINOIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES./ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:C
Authorized Official - Last Name:AGNO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:847-640-2030
Mailing Address - Street 1:500 E HIGGINS ROAD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-1437
Mailing Address - Country:US
Mailing Address - Phone:847-640-2030
Mailing Address - Fax:847-640-2031
Practice Address - Street 1:500 E HIGGINS ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-1437
Practice Address - Country:US
Practice Address - Phone:847-640-2030
Practice Address - Fax:847-640-2031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010181251E00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14D0998502OtherCLIA
IL1851439079Medicare UPIN
IL147725Medicare ID - Type Unspecified