Provider Demographics
NPI:1972533966
Name:PROGRESSIVE HOME HEALTH CARE INC.
Entity Type:Organization
Organization Name:PROGRESSIVE HOME HEALTH CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:POLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-753-6800
Mailing Address - Street 1:601 SKOKIE BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2851
Mailing Address - Country:US
Mailing Address - Phone:847-753-6800
Mailing Address - Fax:847-753-6801
Practice Address - Street 1:601 SKOKIE BLVD
Practice Address - Street 2:SUITE 303
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-2851
Practice Address - Country:US
Practice Address - Phone:847-753-6800
Practice Address - Fax:847-753-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1009851251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL50388OtherBLUE CROSS BLUE SHIELD
IL50388OtherBLUE CROSS BLUE SHIELD
IL147697Medicare ID - Type Unspecified