Provider Demographics
NPI:1841622230
Name:LEGEND HOME HEALTH CARE INC
Entity type:Organization
Organization Name:LEGEND HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALOKWU
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:630-948-5380
Mailing Address - Street 1:8205 S CASS AVE
Mailing Address - Street 2:SUITE 108-A
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-5319
Mailing Address - Country:US
Mailing Address - Phone:630-948-5380
Mailing Address - Fax:630-948-5381
Practice Address - Street 1:8205 S CASS AVE
Practice Address - Street 2:SUITE 108-A
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-5319
Practice Address - Country:US
Practice Address - Phone:630-948-5380
Practice Address - Fax:630-948-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011619251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health