Provider Demographics
NPI:1134152812
Name:HOME HEALTH CARE PROVIDERS, INC.
Entity type:Organization
Organization Name:HOME HEALTH CARE PROVIDERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:BARRERA
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-331-6930
Mailing Address - Street 1:5320 159TH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4705
Mailing Address - Country:US
Mailing Address - Phone:708-331-6930
Mailing Address - Fax:
Practice Address - Street 1:5320 159TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4705
Practice Address - Country:US
Practice Address - Phone:708-331-6930
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1698520251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-7871Medicare ID - Type UnspecifiedPROVIDER NUMBER