Illiuminated Home Health Care LLC.

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

904066000 Issued in MN

Legal business name

ILLIUMINATED HOME HEALTH CARE LLC.

Practice address

175 Charles Ave
328
Saint Paul, MN 55103-2054

Phone

(952) 261-9935

Fax

(651) 224-2857

NPI assigned

Jan 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. William B. Davis

Title

President

Phone

(952) 261-9935

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1902953474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 CHARLES AVENUE",
            "address_2": "328",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55103",
            "telephone_number": "952-261-9935",
            "fax_number": "651-224-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CHARLES AVE",
            "address_2": "328",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032054",
            "telephone_number": "952-261-9935",
            "fax_number": "651-224-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLIUMINATED HOME HEALTH CARE LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-05",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-261-9935",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MN",
            "license": "904066000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faiza Sayid Ikar
• Jodi-Rae M Ikens, PHARM D
• Alison Enuma Ikeogu
• Angela Ngozi Ikeri, DNP, FNP-C, CWOCN
• Ekaterina Andrea Ilin-Grupa, LCSW, LICSW
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• Sarah Imdieke, CNP
• Susan Margaret Imhoff, MA-CCC
• Katherine Louise Imm, RN

• Preferred Provider Organization in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Preferred Provider Organization in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 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.