Provider Demographics
NPI:1881792075
Name:NATIONAL HOME HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:NATIONAL HOME HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-329-9933
Mailing Address - Street 1:5811 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3017
Mailing Address - Country:US
Mailing Address - Phone:847-329-9933
Mailing Address - Fax:847-930-0375
Practice Address - Street 1:5811 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:MORTON GROVE
Practice Address - State:IL
Practice Address - Zip Code:60053-3017
Practice Address - Country:US
Practice Address - Phone:847-329-9933
Practice Address - Fax:847-930-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010480251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147890Medicare Oscar/Certification
IL147890Medicare PIN