Provider Demographics
NPI:1801125539
Name:PLATINUM HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:PLATINUM HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:JACILDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-251-7930
Mailing Address - Street 1:1420 RENAISSANCE DR STE 207
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1342
Mailing Address - Country:US
Mailing Address - Phone:224-251-7930
Mailing Address - Fax:847-423-2968
Practice Address - Street 1:1420 RENAISSANCE DR STE 207
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1342
Practice Address - Country:US
Practice Address - Phone:224-251-7930
Practice Address - Fax:847-423-2968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-08
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011791251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1011791OtherIDPH