Provider Demographics
NPI:1366592594
Name:INTEGRAL HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:INTEGRAL HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:815-730-3358
Mailing Address - Street 1:2364 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60435-1800
Mailing Address - Country:US
Mailing Address - Phone:815-730-3358
Mailing Address - Fax:815-730-3331
Practice Address - Street 1:2364 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60435-1800
Practice Address - Country:US
Practice Address - Phone:815-730-3358
Practice Address - Fax:815-730-3331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010476251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL147885Medicare Oscar/Certification