- Enrollment id
- O20040618000927
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1407809379
- Multiple npi flag
- N
- Ccn
- 147780
- Associate id
- 5193700862
- Organization name
- COMPMED HOME HEALTH, INC.
- Incorporation date
- 2003-12-09
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 2720 S RIVER RD
- Address line 2
- STE 135
- City
- DES PLAINES
- State
- IL
- Zip code
- 600184111
- Practice location type
- HHA BRANCH