Provider Demographics
NPI:1457335838
Name:JOURNEYCARE, INC.
Entity Type:Organization
Organization Name:JOURNEYCARE, INC.
Other - Org Name:JOURNEYCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:CANDYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:847-556-1541
Mailing Address - Street 1:6303 COWBOYS WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0329
Mailing Address - Country:US
Mailing Address - Phone:469-535-8200
Mailing Address - Fax:
Practice Address - Street 1:1717 DEERFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3900
Practice Address - Country:US
Practice Address - Phone:847-467-7423
Practice Address - Fax:847-551-1701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCJ8679OtherMEDICARE RAILROAD
IL1457335838OtherNPI NUMBER
IL362996608-004Medicaid
IL362996608-004Medicaid
IL450690Medicare PIN
IL141527Medicare Oscar/Certification