Provider Demographics
NPI:1851467179
Name:CMK HOME HEALTH AGENCY INC
Entity Type:Organization
Organization Name:CMK HOME HEALTH AGENCY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-725-0532
Mailing Address - Street 1:115 55TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1593
Mailing Address - Country:US
Mailing Address - Phone:630-725-0532
Mailing Address - Fax:630-455-4608
Practice Address - Street 1:115 55TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1593
Practice Address - Country:US
Practice Address - Phone:630-725-0532
Practice Address - Fax:630-455-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010525251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health