Provider Demographics
NPI:1912145152
Name:MIDWEST HOME HEALTH CARE OF FRANKFORT, LLC.
Entity Type:Organization
Organization Name:MIDWEST HOME HEALTH CARE OF FRANKFORT, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETRONILO
Authorized Official - Middle Name:BANATIN
Authorized Official - Last Name:ALDEZA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:815-277-2631
Mailing Address - Street 1:8936 CHARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-9447
Mailing Address - Country:US
Mailing Address - Phone:815-277-2631
Mailing Address - Fax:815-277-2632
Practice Address - Street 1:8936 CHARRINGTON DR
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-9447
Practice Address - Country:US
Practice Address - Phone:815-277-2631
Practice Address - Fax:815-277-2632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041219995251E00000X
IL041204358251E00000X
IL041212612251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health