Provider Demographics
NPI:1871828178
Name:INTEGRATED HOME CARE SERVICES CHICAGO CORPORATION
Entity Type:Organization
Organization Name:INTEGRATED HOME CARE SERVICES CHICAGO CORPORATION
Other - Org Name:INTEGRATED RESPIRATORY SOLUTIONS WESTMONT
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DRISCOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-582-0202
Mailing Address - Street 1:191 S GARY AVE
Mailing Address - Street 2:STE 150
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-2024
Mailing Address - Country:US
Mailing Address - Phone:630-582-0202
Mailing Address - Fax:630-339-3157
Practice Address - Street 1:700 E OGDEN AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-5569
Practice Address - Country:US
Practice Address - Phone:630-908-4141
Practice Address - Fax:630-655-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL35035943332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5126960003Medicare UPIN