Provider Demographics
NPI:1922191105
Name:SAMLAND HOME HEALTH CARE, INC.
Entity Type:Organization
Organization Name:SAMLAND HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SAMPANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-202-4720
Mailing Address - Street 1:4320 W MONTROSE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2016
Mailing Address - Country:US
Mailing Address - Phone:773-202-4720
Mailing Address - Fax:773-202-4725
Practice Address - Street 1:4320 W MONTROSE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2016
Practice Address - Country:US
Practice Address - Phone:773-202-4720
Practice Address - Fax:773-202-4725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL001010361251E00000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
147804Medicare ID - Type Unspecified