Provider Demographics
NPI:1841368487
Name:SUBURBAN HOME RESPIRATORY CARE SERVICE INC
Entity type:Organization
Organization Name:SUBURBAN HOME RESPIRATORY CARE SERVICE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOULIHAN
Authorized Official - Suffix:
Authorized Official - Credentials:RCPT RRT
Authorized Official - Phone:847-933-9600
Mailing Address - Street 1:8440 N KARLOV
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-2103
Mailing Address - Country:US
Mailing Address - Phone:847-933-9600
Mailing Address - Fax:847-933-1858
Practice Address - Street 1:7954 N KARLOV
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076
Practice Address - Country:US
Practice Address - Phone:847-933-9600
Practice Address - Fax:847-933-1858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2020-08-22
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
IL=========001Medicaid
IL=========001Medicaid