Provider Demographics
NPI:1649284068
Name:HEALTHQUEST HOMCARE
Entity type:Organization
Organization Name:HEALTHQUEST HOMCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-637-6168
Mailing Address - Street 1:2500 E. DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018
Mailing Address - Country:US
Mailing Address - Phone:847-297-0137
Mailing Address - Fax:847-297-0138
Practice Address - Street 1:2500 E DEVON AVE
Practice Address - Street 2:SUITE 375
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-4921
Practice Address - Country:US
Practice Address - Phone:847-297-0137
Practice Address - Fax:847-297-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
376J00000X, 251E00000X
IL376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1010481OtherIDPH LICENSE
147931Medicare Oscar/Certification