Provider Demographics
NPI:1538257712
Name:WEBRIDGE HOME HEALTH CORPORATION
Entity type:Organization
Organization Name:WEBRIDGE HOME HEALTH CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ENERO
Authorized Official - Last Name:KAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-673-8760
Mailing Address - Street 1:7301 N LINCOLN AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1709
Mailing Address - Country:US
Mailing Address - Phone:847-673-8760
Mailing Address - Fax:847-673-8761
Practice Address - Street 1:7301 N LINCOLN AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1709
Practice Address - Country:US
Practice Address - Phone:847-673-8760
Practice Address - Fax:847-673-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010605251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010605OtherFACILITY LICENSE