Provider Demographics
NPI:1386795904
Name:SHAY HEALTH CARE SERVICES, INC
Entity type:Organization
Organization Name:SHAY HEALTH CARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LALLKY
Authorized Official - Suffix:
Authorized Official - Credentials:BSRN
Authorized Official - Phone:708-535-4300
Mailing Address - Street 1:5730 159TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-3163
Mailing Address - Country:US
Mailing Address - Phone:708-535-4300
Mailing Address - Fax:708-535-7519
Practice Address - Street 1:5730 159TH ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-3163
Practice Address - Country:US
Practice Address - Phone:708-535-4300
Practice Address - Fax:708-535-7519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1001064251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9758OtherBCBS
IL=========001Medicaid
IL=========001Medicaid