| Organization Name: | SOUTH SUBURBAN HEALTHCARE, INC |
| NPI Number: | 1063653020 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM HISEY PIERSON (PRESIDENT) |
| Mailing Address: | 17055 Harlem Ave Tinley Park |
| State: | IL US |
| Postal Code: | 604772739 |
| Phone Number: | 7085322273 |
| Fax Number: | 7086336100 |
| NPI Enumeration Date: | 03/20/2009 |
| NPI Last Update Date: | 03/20/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251F00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Home Infusion |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |