Supportive Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

4243128 Issued in IL

Legal business name

SUPPORTIVE HOME HEALTH LLC

Practice address

1540 Hecht Dr
Suite H
Bartlett, IL 60103-1699

Phone

(630) 830-8000

Fax

(630) 830-8004

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Raymond Dwight Dolan, RN

Title

Vice President of Operations

Phone

(630) 830-8000

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1568555316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 BRIDLE LN",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031853",
            "telephone_number": "708-436-6949",
            "fax_number": "630-837-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 HECHT DR",
            "address_2": "SUITE H",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031699",
            "telephone_number": "630-830-8000",
            "fax_number": "630-830-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPPORTIVE HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "DWIGHT",
        "authorized_official_title_or_position": "VICE PRESIDENT OF OPERATIONS",
        "authorized_official_telephone_number": "630-830-8000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "4243128",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "IL",
            "license": "203.000883",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Bartlett, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.