Provider Demographics
NPI:1316698517
Name:MARINA HOME HEALTHCARE
Entity type:Organization
Organization Name:MARINA HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHD
Authorized Official - Prefix:
Authorized Official - First Name:RANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADDAWI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-402-8328
Mailing Address - Street 1:47 DURHAM CT # 14
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-7938
Mailing Address - Country:US
Mailing Address - Phone:630-402-8328
Mailing Address - Fax:
Practice Address - Street 1:47 DURHAM CT # 14
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-7938
Practice Address - Country:US
Practice Address - Phone:630-402-8328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health