Provider Demographics
NPI:1780989145
Name:CONNIE HOME HEALTH CARE,NFP
Entity type:Organization
Organization Name:CONNIE HOME HEALTH CARE,NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-790-4000
Mailing Address - Street 1:21220 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2532
Mailing Address - Country:US
Mailing Address - Phone:708-790-4000
Mailing Address - Fax:
Practice Address - Street 1:21220 MAPLE ST
Practice Address - Street 2:
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-2532
Practice Address - Country:US
Practice Address - Phone:708-790-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization