Provider Demographics
NPI:1912920091
Name:HORIZON HOME HEALTH CARE INC
Entity Type:Organization
Organization Name:HORIZON HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DE VERA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:312-225-7706
Mailing Address - Street 1:2929 S WABASH AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3243
Mailing Address - Country:US
Mailing Address - Phone:312-225-7706
Mailing Address - Fax:312-225-7736
Practice Address - Street 1:2929 S WABASH AVE STE 202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3243
Practice Address - Country:US
Practice Address - Phone:312-225-7706
Practice Address - Fax:312-225-7736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010423251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL147829Medicare Oscar/Certification