Organization
SUPPORTIVE HOME HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND DWIGHT DOLAN RN (VICE PRESIDENT OF OPERATIONS)
(630) 830-8000
Entity
Organization
Contact information
Practice address
1540 HECHT DR, SUITE H, BARTLETT, IL 60103-1699
(630) 830-8000
(630) 830-8004
Mailing address
1540 BRIDLE LN, BARTLETT, IL 60103-1853
(708) 436-6949
(630) 837-0230
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4243128
IL
332BX2000X
Oxygen Equipment & Supplies (DME)
203.000883
IL
Other
Enumeration date
10/02/2006
Last updated
01/17/2012
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