Provider Demographics
NPI:1699736801
Name:ELMHURST MEMORIAL HOME HEALTH
Entity type:Organization
Organization Name:ELMHURST MEMORIAL HOME HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-833-8200
Mailing Address - Street 1:855 N CHURCH COURT
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-1005
Mailing Address - Country:US
Mailing Address - Phone:630-758-7000
Mailing Address - Fax:630-758-7007
Practice Address - Street 1:855 N CHURCH CT
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-1036
Practice Address - Country:US
Practice Address - Phone:630-758-7000
Practice Address - Fax:630-758-7007
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELMHURST MEMORIAL HOME HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02232463OtherBLUE CROSS
IL=========03Medicaid
IL4818280001Medicare NSC