Provider Demographics
NPI:1528259975
Name:WELLSPRING HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:WELLSPRING HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHROYER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:630-968-7777
Mailing Address - Street 1:3590 HOBSON RD STE 404
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1492
Mailing Address - Country:US
Mailing Address - Phone:630-968-7777
Mailing Address - Fax:630-968-7770
Practice Address - Street 1:3590 HOBSON RD STE 404
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1492
Practice Address - Country:US
Practice Address - Phone:630-968-7777
Practice Address - Fax:630-968-7770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000103251E00000X
IL1010879251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health