1. Home
  2. Directory
  3. Illinois
  4. O Fallon
  5. Nursing Care
  6. NPI Profile

PHOENIX HOME CARE ILLINOIS, LLC
NPI 1720465834
Nursing Care in O Fallon, IL

Active since April 28, 2015
784 WALL ST, SUITE B, O FALLON, IL 62269(314) 205-3020(314) 205-3031 Get Directions Write a Review

NPPES record last updated: December 3, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Phoenix Home Care Illinois, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHOENIX HOME CARE ILLINOIS, LLC (NPI 1720465834) is a healthcare organization registered as a nursing care in O Fallon, Illinois and active in the NPI registry since April 2015. The organization lists George Scott Herman, President/secretary, as its authorized official.

NPPES Registry Identity

NPI1720465834
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NamePHOENIX HOME CARE ILLINOIS, LLC
Location Address784 WALL ST, SUITE BO Fallon, IL 62269-1959
Mailing Address3450 N. Rock Rd, #213 Attn Debra MullenWichita, KS 67226 · (316) 688-5511 · Fax (314) 205-3031
Phone(314) 205-3020
Fax(314) 205-3031
Organization SubpartYesParent: Phoenix Home Care, Inc
Authorized OfficialGeorge Scott HermanPresident/secretary · (512) 632-7156
Enumeration DateApril 28, 2015
Last NPPES UpdateDecember 3, 2021
NPPES CertifiedDecember 3, 2021
✔ NPI 1720465834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
Definition

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.

784 WALL ST, O Fallon, IL 62269
Open in Google Maps ↗

Other Identifiers 1

Medicaid266501303MO

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONARCH BEHAVIORAL CARE, LLC
Behavior Analyst
784 WALL ST, 100J
O FALLON, IL 62269
St. Clair County (715) 703-0573
MRS. ANGELA DION MITCHELL LCPC
Counselor
784 WALL ST, SUITE 100
O'FALLON, IL 62269
St. Clair County (618) 515-5158

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Phoenix Home Care Illinois, LLC's NPI number?

The NPI number for Phoenix Home Care Illinois, LLC is 1720465834. It was assigned to this organization in the NPPES registry on April 28, 2015.

Where is Phoenix Home Care Illinois, LLC located?

Phoenix Home Care Illinois, LLC is located at 784 Wall St Suite B, O Fallon, IL 62269. The listed phone number is (314) 205-3020.

What is Phoenix Home Care Illinois, LLC's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

When was this NPI record last updated?

The NPPES record for Phoenix Home Care Illinois, LLC was last updated on December 3, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.