Organization
GREATLAND HOME HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONSURU HASSAN (EXECUTIVE DIRECTOR)
(630) 548-2126
Entity
Organization
Contact information
Practice address
24W500 MAPLE AVE, SUITE 205, NAPERVILLE, IL 60540-6055
(630) 548-2126
(630) 364-1506
Mailing address
PO BOX 1010, BOLINGBROOK, IL 60440-0141
(630) 548-2126
(630) 364-1506
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1010350
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50432
BLUE CROSS BLUE SHIELD
IL
01
—
7717763
AETNA
IL
01
—
IL1010350
STATE LICENSE
IL
Enumeration date
10/29/2005
Last updated
01/09/2015
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