Organization
CELESTIAL HOME HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK R HERNANDEZ (ADMINISTRATOR)
(773) 625-3326
Entity
Organization
Contact information
Practice address
3559 N CUMBERLAND AVE, SUITE 106/107, CHICAGO, IL 60634-2865
(773) 625-3326
(773) 625-1948
Mailing address
3559 N CUMBERLAND AVE., SUITE 106/107, CHICAGO, IL 60634-2865
(773) 625-3326
(773) 625-1948
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1010389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14-7861
MEDICARE
IL
Enumeration date
10/02/2006
Last updated
03/11/2009
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