Provider Demographics
NPI:1831203546
Name:WESTERN ILLINOIS HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:WESTERN ILLINOIS HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-734-9376
Mailing Address - Street 1:2 INDUSTRIAL PARK AVE
Mailing Address - Street 2:PO BOX 856
Mailing Address - City:MONMOUTH
Mailing Address - State:IL
Mailing Address - Zip Code:61462-9698
Mailing Address - Country:US
Mailing Address - Phone:309-734-9376
Mailing Address - Fax:309-734-5338
Practice Address - Street 1:2 INDUSTRIAL PARK AVE
Practice Address - Street 2:
Practice Address - City:MONMOUTH
Practice Address - State:IL
Practice Address - Zip Code:61462-9698
Practice Address - Country:US
Practice Address - Phone:309-734-9376
Practice Address - Fax:309-734-5338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1006816251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9738OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid
IL147204Medicare ID - Type UnspecifiedMEDICARE