Provider Demographics
NPI:1285882068
Name:HOME HEALTH SUPPLIES INC
Entity type:Organization
Organization Name:HOME HEALTH SUPPLIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAISTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-660-8930
Mailing Address - Street 1:2200 S MAIN ST
Mailing Address - Street 2:SUITE 213
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-5334
Mailing Address - Country:US
Mailing Address - Phone:630-424-2850
Mailing Address - Fax:708-398-7610
Practice Address - Street 1:2200 S MAIN ST
Practice Address - Street 2:SUITE 213
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5334
Practice Address - Country:US
Practice Address - Phone:630-424-2850
Practice Address - Fax:708-398-7610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065312208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty