Provider Demographics
NPI:1922754787
Name:THERESA'S HOME CARE
Entity Type:Organization
Organization Name:THERESA'S HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:BICOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-525-2816
Mailing Address - Street 1:5044 DARLENE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-525-2816
Mailing Address - Fax:847-680-1635
Practice Address - Street 1:5044 DARLENE DRIVE
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-525-2816
Practice Address - Fax:847-782-0506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility