Provider Demographics
NPI:1295744738
Name:MEDICAL PROFESSIONALS FOR HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:MEDICAL PROFESSIONALS FOR HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEKOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-487-2400
Mailing Address - Street 1:7928 S KING DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-3702
Mailing Address - Country:US
Mailing Address - Phone:773-487-2400
Mailing Address - Fax:773-487-8515
Practice Address - Street 1:7928 S KING DRIVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-3702
Practice Address - Country:US
Practice Address - Phone:773-487-2400
Practice Address - Fax:773-487-8515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL100348251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9651OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid
IL9651OtherBLUE CROSS BLUE SHIELD