Provider Demographics
NPI:1083717953
Name:CRESCENT HOME HEALTHCARE, INC.
Entity type:Organization
Organization Name:CRESCENT HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARJANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRAJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-427-1220
Mailing Address - Street 1:1S443 SUMMIT AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3972
Mailing Address - Country:US
Mailing Address - Phone:773-427-1220
Mailing Address - Fax:773-557-7662
Practice Address - Street 1:1S443 SUMMIT AVE STE 204
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-3972
Practice Address - Country:US
Practice Address - Phone:773-427-1220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010484251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010484OtherIDPH LICENSE