Provider Demographics
NPI:1316131824
Name:IJ HEALTHCARE NURSING RESOURCE
Entity type:Organization
Organization Name:IJ HEALTHCARE NURSING RESOURCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AURELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NADAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-488-9423
Mailing Address - Street 1:325 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60177-1764
Mailing Address - Country:US
Mailing Address - Phone:847-488-9423
Mailing Address - Fax:
Practice Address - Street 1:325 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SOUTH ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60177-1764
Practice Address - Country:US
Practice Address - Phone:847-488-9423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010445251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147939Medicare Oscar/Certification