Provider Demographics
NPI:1932305950
Name:GSP UNITED LLC
Entity Type:Organization
Organization Name:GSP UNITED LLC
Other - Org Name:INTERIM HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BULGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-359-6660
Mailing Address - Street 1:188 W INDUSTRIAL DR
Mailing Address - Street 2:SUITE 124
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1623
Mailing Address - Country:US
Mailing Address - Phone:630-359-6660
Mailing Address - Fax:630-279-7325
Practice Address - Street 1:188 W INDUSTRIAL DR
Practice Address - Street 2:SUITE 124
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1623
Practice Address - Country:US
Practice Address - Phone:630-359-6660
Practice Address - Fax:630-279-7325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2007-N0020251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL611413200OtherDEPARTMENT OF LABOR
IL1633280OtherBLUE CROSS
IL61271OtherPRINCIPAL LIFE INSURANCE
IL5911112669OtherSTATE OF WASHINGTON
IL000002649OtherHUMANA
IL371442495001Medicaid
IL37308OtherALLIED HEALTH
IL5215621OtherAETNA
IL14-7182Medicare ID - Type UnspecifiedMEDICARE