Organization
INDEPENDENCE HOME HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SOOMAR RAJPER PT (PRESIDENT/OWNER)
(773) 481-6525
Entity
Organization
Contact information
Practice address
5648 W LAWRENCE AVE STE A, CHICAGO, IL 60630-3220
(773) 481-6525
(773) 481-6528
Mailing address
5648 W. LAWRENCE AVE,, SUITE A, CHICAGO, IL 60630-3220
(773) 481-6525
(773) 481-6528
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1011389
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011389
ILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE
IL
Enumeration date
12/30/2011
Last updated
12/30/2011
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