| Organization Name: | PROHEALTH HOMECARE LLC |
| NPI Number: | 1013927318 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MAZHAR H TABREZI (MANAGER/AGENCY SUPERVISOR) |
| Mailing Address: | 2604 Dempster St Ste#205 Park Ridge |
| State: | IL US |
| Postal Code: | 600688412 |
| Phone Number: | 8477950800 |
| Fax Number: | 8477950808 |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 01/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | 1010403 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |