Provider Demographics
NPI:1902094063
Name:RW NURSESTAFFERS
Entity type:Organization
Organization Name:RW NURSESTAFFERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:TIRANEY
Authorized Official - Middle Name:
Authorized Official - Last Name:REDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-306-2547
Mailing Address - Street 1:3439 W 82ND PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-2503
Mailing Address - Country:US
Mailing Address - Phone:773-386-3439
Mailing Address - Fax:773-913-2765
Practice Address - Street 1:9449 S KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2325
Practice Address - Country:US
Practice Address - Phone:773-386-3439
Practice Address - Fax:773-913-2765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2007-N1041251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health