Provider Demographics
NPI:1700113545
Name:DEPENDABLE HOME MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:DEPENDABLE HOME MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:CORRALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-539-5883
Mailing Address - Street 1:138 W HIGGINS RD STE B
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-4918
Mailing Address - Country:US
Mailing Address - Phone:224-539-5883
Mailing Address - Fax:847-754-3303
Practice Address - Street 1:138 W HIGGINS RD STE B
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-4918
Practice Address - Country:US
Practice Address - Phone:224-539-5883
Practice Address - Fax:847-754-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-16
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
291U00000X
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL063=========001Medicaid