Provider Demographics
NPI:1295922888
Name:JAGEN HOME HEALTH SERVICES,INC
Entity type:Organization
Organization Name:JAGEN HOME HEALTH SERVICES,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:CECILA
Authorized Official - Last Name:PELAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-631-2573
Mailing Address - Street 1:5151 N HARLEM AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-3686
Mailing Address - Country:US
Mailing Address - Phone:773-631-2573
Mailing Address - Fax:773-631-2593
Practice Address - Street 1:5151 N HARLEM AVE STE 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-3686
Practice Address - Country:US
Practice Address - Phone:773-631-2573
Practice Address - Fax:773-631-2593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010736251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health