Provider Demographics
NPI:1801640693
Name:IMMACULATE CARE HOME HEALTH LLC
Entity type:Organization
Organization Name:IMMACULATE CARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIA LILIBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NATIVIDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-616-8788
Mailing Address - Street 1:1320 TOWER RD STE 130
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4309
Mailing Address - Country:US
Mailing Address - Phone:224-616-8788
Mailing Address - Fax:312-940-5809
Practice Address - Street 1:1320 TOWER RD STE 130
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4309
Practice Address - Country:US
Practice Address - Phone:224-616-8788
Practice Address - Fax:312-940-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health