Divine Providence Home Health Agency, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1010341 Issued in IL

Legal business name

DIVINE PROVIDENCE HOME HEALTH AGENCY, INC.

Practice address

3550 W Peterson Ave
Suite 304
Chicago, IL 60659-3270

Phone

(773) 433-3320

Fax

(773) 433-3329

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Arnold Jay Donato

Title

Chief Financial Officer

Phone

(773) 433-3320

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349395200000",
    "number": "1942307145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 W PETERSON AVE",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593270",
            "telephone_number": "773-433-3320",
            "fax_number": "773-433-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 W PETERSON AVE",
            "address_2": "SUITE 304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593270",
            "telephone_number": "773-433-3320",
            "fax_number": "773-433-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE PROVIDENCE HOME HEALTH AGENCY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2012-10-05",
        "status": "A",
        "authorized_official_last_name": "DONATO",
        "authorized_official_first_name": "ARNOLD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-433-3320"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1010341",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH LICENSE",
            "identifier": "1010341",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Divine Recovery Hope Clinic
• Mara Divis, DO
• Division Anesthesia Group PC
• Division Chiropractic & Acupuncture

• Home Health Agency in Chicago, IL
• Providers in Chicago, 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 Oct 5, 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.