Provider Demographics
NPI:1629868831
Name:SPITICARE HOME SERVICES
Entity type:Organization
Organization Name:SPITICARE HOME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-702-2888
Mailing Address - Street 1:9332 LANDINGS LN UNIT 601
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5247
Mailing Address - Country:US
Mailing Address - Phone:347-702-2888
Mailing Address - Fax:
Practice Address - Street 1:9332 LANDINGS LN UNIT 601
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5247
Practice Address - Country:US
Practice Address - Phone:347-702-2888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-09
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist