Provider Demographics
NPI:1801126453
Name:JUBILEE PROFESSIONAL HEALTHCARE, INC.
Entity type:Organization
Organization Name:JUBILEE PROFESSIONAL HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:847-421-7131
Mailing Address - Street 1:201 E ARMY TRAIL RD
Mailing Address - Street 2:SUITE 100-D
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 E ARMY TRAIL RD
Practice Address - Street 2:SUITE 100-D
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2150
Practice Address - Country:US
Practice Address - Phone:847-421-7131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health