Illinois Express Home Care

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

4000369 Issued in IL

Legal business name

ILLINOIS EXPRESS HOME CARE

Practice address

4601 State St
East Saint Louis, IL 62205-1359

Phone

(314) 727-0453

NPI assigned

Oct 4, 2012

Organization subpart

Yes

Parent organization

EXPRESS HOME CAREAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Diane Shelton

Title

Administrator

Phone

(314) 727-0453

Specialties & licenses 1

Addresses

Part of

Express Home Care

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1013269737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 OAKDALE AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631215437",
            "telephone_number": "314-727-0453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 STATE ST",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622051359",
            "telephone_number": "314-727-0453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS EXPRESS HOME CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXPRESS HOME CARE",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "314-727-0453",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": "4000369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in East Saint Louis, IL
• Providers in East Saint Louis, IL by specialty
• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.