Provider Demographics
NPI:1811169139
Name:ESPERANZA HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ESPERANZA HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:GIOVANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-562-0755
Mailing Address - Street 1:2130 N 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-3006
Mailing Address - Country:US
Mailing Address - Phone:708-452-7610
Mailing Address - Fax:708-452-7612
Practice Address - Street 1:2130 N 77TH AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-3006
Practice Address - Country:US
Practice Address - Phone:708-452-7610
Practice Address - Fax:708-452-7612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2009-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010855251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
148066Medicare Oscar/Certification