Provider Demographics
NPI:1770519993
Name:SPECTRUM HOME HEALTH CARE, INC
Entity type:Organization
Organization Name:SPECTRUM HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:306-745-8080
Mailing Address - Street 1:145 E ALGONQUIN RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-5323
Mailing Address - Country:US
Mailing Address - Phone:847-607-6555
Mailing Address - Fax:888-446-2250
Practice Address - Street 1:5901 N CICERO AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5717
Practice Address - Country:US
Practice Address - Phone:773-202-9167
Practice Address - Fax:773-202-9168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010514251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147908Medicare ID - Type UnspecifiedPROVIDER NUMBER