Provider Demographics
NPI:1922024413
Name:PROFESSIONAL HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:PROFESSIONAL HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYNELL
Authorized Official - Middle Name:
Authorized Official - Last Name:PARRENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-813-6475
Mailing Address - Street 1:2800 S. RIVER RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018
Mailing Address - Country:US
Mailing Address - Phone:847-813-6475
Mailing Address - Fax:847-813-9834
Practice Address - Street 1:2800 S. RIVER RD
Practice Address - Street 2:SUITE 140
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018
Practice Address - Country:US
Practice Address - Phone:847-813-6475
Practice Address - Fax:847-813-9834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010337251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147793Medicare ID - Type Unspecified