14D1107099 CLIA NUMBER - CENTER OF ILLINOIS HOME HEALTHCARE

Laboratory Demographics

CLIA Number: 14D1107099

Facility Name: CENTER OF ILLINOIS HOME HEALTHCARE

Facility Address:
855 E GOLF ROAD, SUITE 2147
ARLINGTON HEIGHTS, IL
ZIP 60005
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Facility Phone Number: 847 437-0774

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1083847891

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name	Field Value
CLIA Number	14D1107099
LAB Type	Home Health Agency
Facility Name	CENTER OF ILLINOIS HOME HEALTHCARE
Street	855 E GOLF ROAD, SUITE 2147
City	ARLINGTON HEIGHTS
State	IL
ZIP	60005
Phone	847 437-0774
CertificateType	4
CertificateEffectiveDate	10/28/2023
CertificateExpirationDate	10/27/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024