Provider Demographics
NPI:1730410622
Name:ALLIANCE HOMW SERVICE, INC.
Entity type:Organization
Organization Name:ALLIANCE HOMW SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V P DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEILER
Authorized Official - Suffix:
Authorized Official - Credentials:R N
Authorized Official - Phone:815-479-0220
Mailing Address - Street 1:2800 S. RIVER RD.
Mailing Address - Street 2:SUIT 470
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60018-8057
Mailing Address - Country:US
Mailing Address - Phone:847-847-1519
Mailing Address - Fax:815-479-2210
Practice Address - Street 1:2800 S RIVER RD
Practice Address - Street 2:SUIT 470
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-6001
Practice Address - Country:US
Practice Address - Phone:847-847-1519
Practice Address - Fax:815-479-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-18
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000617302R00000X
IL4000301302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization