Provider Demographics
NPI:1124279799
Name:AUSPEX HOME HEALTH CARE SERVICES INCORPORATED
Entity type:Organization
Organization Name:AUSPEX HOME HEALTH CARE SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LUCHIE
Authorized Official - Middle Name:SAILE
Authorized Official - Last Name:PACULBA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-822-1126
Mailing Address - Street 1:6246 N PULASKI RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5100
Mailing Address - Country:US
Mailing Address - Phone:773-283-2648
Mailing Address - Fax:773-283-3565
Practice Address - Street 1:6246 N PULASKI RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5100
Practice Address - Country:US
Practice Address - Phone:773-283-2648
Practice Address - Fax:773-283-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010856251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL148215Medicare PIN