Provision Home Healthcare, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVISION HOME HEALTHCARE, INC

Practice address

17065 Dixie Hwy Ste 36
Hazel Crest, IL 60429-1384

Phone

(708) 335-3689

NPI assigned

Feb 21, 2008

Organization subpart

No

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

Authorized official

Name

Georgena Wiley

Title

Administrator

Phone

(708) 335-3689

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1447429618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17065 DIXIE HWY STE 36",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291384",
            "telephone_number": "708-335-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17065 DIXIE HWY STE 36",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604291384",
            "telephone_number": "708-335-3689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVISION HOME HEALTHCARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-21",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "GEORGENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "708-335-3689"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.