Basic Information
| Provider Information | |||||||||
| NPI: | 1942263496 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ADDUS HEALTHCARE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2401 S PLUM GROVE RD | ||||||||
| Address2: | |||||||||
| City: | PALATINE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60067 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8473035300 | ||||||||
| FaxNumber: | 8473035376 | ||||||||
| Practice Location | |||||||||
| Address1: | 20280 GOVERNORS HIGHWAY | ||||||||
| Address2: | STE 301 | ||||||||
| City: | OLYMPIA FIELDS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60461 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082834240 | ||||||||
| FaxNumber: | 7082834241 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/07/2006 | ||||||||
| LastUpdateDate: | 06/18/2009 | ||||||||
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| AuthorizedOfficialLastName: | KUMARICH | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | NATIONAL CONTRACTS | ||||||||
| AuthorizedOfficialTelephone: | 8473035300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN, MS, MBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251F00000X | N | Agencies | Home Infusion | 251J00000X | N | Agencies | Nursing Care | 251C00000X | N | Agencies | Day Training, Developmentally Disabled Services | 251E00000X | 1645110 | IL | Y | Agencies | Home Health |
No ID Information.