Provider Demographics
NPI:1184954190
Name:WOUND & REHAB HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:WOUND & REHAB HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:847-609-2803
Mailing Address - Street 1:514 TEELA LN
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1230
Mailing Address - Country:US
Mailing Address - Phone:847-609-2803
Mailing Address - Fax:847-692-6112
Practice Address - Street 1:700 BUSSE HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-2402
Practice Address - Country:US
Practice Address - Phone:847-692-6000
Practice Address - Fax:847-692-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-14
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011294251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health