Provider Demographics
NPI:1881671857
Name:CRITICAL HOME CARE INC
Entity Type:Organization
Organization Name:CRITICAL HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:
Authorized Official - Last Name:HARAF
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:630-530-0280
Mailing Address - Street 1:401 E NORTH AVE
Mailing Address - Street 2:SUITE 16
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-1218
Mailing Address - Country:US
Mailing Address - Phone:630-530-0280
Mailing Address - Fax:
Practice Address - Street 1:401 E NORTH AVE
Practice Address - Street 2:SUITE 16
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-1218
Practice Address - Country:US
Practice Address - Phone:630-530-0280
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203001695332B00000X
IL51032331333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL0425190001Medicare NSC