Provider Demographics
NPI:1265695928
Name:UNICARE HOME HEALTH SERVICES INCORPORATED
Entity type:Organization
Organization Name:UNICARE HOME HEALTH SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEL
Authorized Official - Middle Name:RUTAQUIO
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-444-8445
Mailing Address - Street 1:6006 159TH ST
Mailing Address - Street 2:BUILDING A, SUITE 2A
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2904
Mailing Address - Country:US
Mailing Address - Phone:708-444-8445
Mailing Address - Fax:708-429-2920
Practice Address - Street 1:6006 159TH ST
Practice Address - Street 2:BUILDING A, SUITE 2A
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2904
Practice Address - Country:US
Practice Address - Phone:708-444-8445
Practice Address - Fax:708-429-2920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010836251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010836OtherSTATE LICENSE