Provider Demographics
NPI:1134978893
Name:ELIJAH HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:ELIJAH HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAIMOT
Authorized Official - Middle Name:
Authorized Official - Last Name:GERING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-458-0499
Mailing Address - Street 1:195 WAUKEGAN RD UNIT 370
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-5186
Mailing Address - Country:US
Mailing Address - Phone:815-382-2073
Mailing Address - Fax:
Practice Address - Street 1:195 WAUKEGAN RD UNIT 370
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-5186
Practice Address - Country:US
Practice Address - Phone:815-382-2073
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health