# SUPPORTIVE HOME HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568555316
- **Authorized official:** MR. RAYMOND DWIGHT DOLAN RN (VICE PRESIDENT OF OPERATIONS)
- **Authorized official phone:** (630) 830-8000

## Contact information

- **Practice address:** 1540 HECHT DR, SUITE H, BARTLETT, IL 60103-1699
- **Practice address phone:** (630) 830-8000
- **Practice address fax:** (630) 830-8004
- **Mailing address:** 1540 BRIDLE LN, BARTLETT, IL 60103-1853
- **Mailing address phone:** (708) 436-6949
- **Mailing address fax:** (630) 837-0230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 4243128 | IL | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 203.000883 | IL | — |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 01/17/2012