Provider Demographics
NPI:1548358872
Name:VENUS HOME HEALTH, INC.
Entity type:Organization
Organization Name:VENUS HOME HEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:P
Authorized Official - Last Name:DIPLOMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-867-0400
Mailing Address - Street 1:4701 N CUMBERLAND AVE
Mailing Address - Street 2:SUITE 8-9
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-2905
Mailing Address - Country:US
Mailing Address - Phone:708-867-0400
Mailing Address - Fax:708-867-0404
Practice Address - Street 1:4701 N CUMBERLAND AVE
Practice Address - Street 2:SUITE 8-9
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2905
Practice Address - Country:US
Practice Address - Phone:708-867-0400
Practice Address - Fax:708-867-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010391251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147892Medicare ID - Type UnspecifiedHOME HEALTH