Provider Demographics
NPI:1891532073
Name:BEWELL HOME CARE INC.
Entity type:Organization
Organization Name:BEWELL HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MA LORELA
Authorized Official - Middle Name:
Authorized Official - Last Name:QUERIMIT
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:773-704-4102
Mailing Address - Street 1:13139 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2026
Mailing Address - Country:US
Mailing Address - Phone:773-704-4102
Mailing Address - Fax:773-754-8705
Practice Address - Street 1:3525 W PETERSON AVE STE 500
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3317
Practice Address - Country:US
Practice Address - Phone:773-704-4102
Practice Address - Fax:773-754-8705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty