Organization
CROWN HOME HEALTH AGENCY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN CARLOS RUBIO (PRESIDENT)
(773) 481-1353
Entity
Organization
Contact information
Practice address
6336 N CICERO AVE STE 202, CHICAGO, IL 60646-4448
(773) 481-1353
(773) 481-1778
Mailing address
6336 N CICERO AVE STE 202, CHICAGO, IL 60646-4448
(773) 481-1353
(773) 481-1778
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1007004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS5049
HOME HEALTH AGENCY
IL
Enumeration date
02/12/2007
Last updated
01/28/2022
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