- Enrollment id
- O20080103000229
- Enrollment state
- IL
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1992910558
- Multiple npi flag
- N
- Ccn
- 148176
- Associate id
- 4688754674
- Organization name
- SPECTRUM NURSES INCORPORATED
- Incorporation date
- 2002-04-03
- Incorporation state
- IL
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 280 S SCHMIDT RD
- City
- BOLINGBROOK
- State
- IL
- Zip code
- 604402723