Provider Demographics
NPI:1912209735
Name:OASIS OF CARE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:OASIS OF CARE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMENCITA
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:AGNO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-329-5270
Mailing Address - Street 1:7301 N LINCOLN AVE
Mailing Address - Street 2:SUITE 123
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1709
Mailing Address - Country:US
Mailing Address - Phone:847-329-5270
Mailing Address - Fax:847-329-5271
Practice Address - Street 1:7301 N LINCOLN AVE
Practice Address - Street 2:SUITE 123
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1709
Practice Address - Country:US
Practice Address - Phone:847-329-5270
Practice Address - Fax:847-329-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011026251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1011026OtherHOME HEALTH AGENCY LICENSE
IL14D1102109OtherCLIA