14D2003693 CLIA NUMBER - VINTAGE HEALTHCARE SERVICES INC

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Laboratory Demographics

CLIA Number: 14D2003693

Facility Name: VINTAGE HEALTHCARE SERVICES INC

Facility Address:
20300 GOVERNORS HWY
OLYMPIA FIELDS, IL
ZIP 60461
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Facility Phone Number: 630 517-0191

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1629323167

Taxonomy: 251J00000X - Nursing Care
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

CLIA Record

Field Name	Field Value
CLIA Number	14D2003693
LAB Type	Home Health Agency
Facility Name	VINTAGE HEALTHCARE SERVICES INC
Street	20300 GOVERNORS HWY
City	OLYMPIA FIELDS
State	IL
ZIP	60461
Phone	630 517-0191
CertificateType	4
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	Waiver

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