Provider Demographics
NPI:1134399207
Name:LINCOLN PARK HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:LINCOLN PARK HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOV
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:773-465-3006
Mailing Address - Street 1:6045 N LINCOLN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-2435
Mailing Address - Country:US
Mailing Address - Phone:773-465-3006
Mailing Address - Fax:773-465-3007
Practice Address - Street 1:6045 N LINCOLN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2435
Practice Address - Country:US
Practice Address - Phone:773-465-3006
Practice Address - Fax:773-465-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-05
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010787251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health