Please Note: If you fill out this form anonymously we will not have a way to get in touch with you to provide you with the information requested.
PLEASE include your name and a method for us to reach you! Thanks

Please fax to Home Bound Healthcare, Inc. the following information to our appropriate local office fax numbers:
  1. Physician’s order for Home Health Services/ Discharge Order
  2. Face Sheet for the patient, including demographic, and contact information
  3. Insurance/ Payor Information (copy of insurance card)

For additional information regarding the referrals process contact:

Sheri Maurer - Home Bound Healthcare Marketing Director at 708-798-0800 x604

Chris Welch, LNHA - Regional Administrator

Kimberly Park, LNHA - Regional Private Duty Administrator
Flossmoor Office
Fax 708-798-0870
Phone 708-798-0800

Home Health:

Steve Barton, Marketing Specialist

DME:
   Helena Mathews, LNHA Administrator


Private Duty:
          Fax 708-338-2503
         Phone 708-338-2500

Julie Mitra, RN, BSN Private Duty Director

Covering the counties of:

Illinois: Lake, Cook, DuPage, Will, Kankakee, Kendall, Grundy, LaSalle, Bureau, Putnam, Stark, Marshall, Boone, McHenry
 
Moline Office
Fax 309-762-6909
Phone 309-762-7900

Home Health:
Tara Wassell, Marketing Specialist

Private Duty:
Judy Sawyer, Private Duty Coordinator

DME:
Carol Zambrano, RN, Administrator


Covering the counties of:

Illinois: Whiteside, Bureau, Stark, Henry, Knox, Rock Island, Mercer, Warren, Henderson

Iowa: Clinton, Muscatine, Scott
 
Peoria Office
Fax 309-589-0889
Phone 309-589-0888

Home Health:
Susan Wiley, Marketing Specialist

DME:
Ruby Rosalem, LNHA Administrator

Private Duty:
Dawn Graves, Private Duty Coordinator


Covering the counties of:

Illinois: Peoria, Putnam, Marshall, Woodford, Tazewell, Livingston, McLean, Fulton, Mason
 
Sycamore Office
Fax 815-895-3232
Phone 815-895-9898

Home Health/Private Duty:
Sandra Erickson, MBA, LNHA Administrator

DME:
Daniel Ortiz, Marketing Specialist

Covering the counties of:


Illinois: Stephenson, Winnebago, Ogle, Lee, DeKalb, Kane
 
Springfield Office
Fax 217-753-2270
Phone 217-753-2260

Home Health/Private Duty:
Pam Turner, LNHA Administrator

DME:
Wendy Smith, Marketing Specialist


Covering the counties of:

Illinois: Sangamon, Morgan, Pike, Adams, Christian, Cass, Menard, Scott, Brown
 
Peru Office
Fax 815-220-8828
Phone 815-220-8808

Home Health:
Robbin Squires, Marketing Specialist

DME:
Tim Maltas, Business Branch Manager


Private Duty:
          Fax 815-875-8828
        Phone 815-879-8808

Tara Bitting, Private Duty Coordinator


Covering the counties of:

Illinois: Kendall, Grundy, LaSalle, Bureau, Putnam, Stark, Marshall
 

Outpatient Rehabilitation Office
Fax 847-288-1650
Phone 847-288-1660

Outpatient Therapy:
Hazel Enriquez, Physical Therapist
Las Vegas Office
Fax 702-433-0801
Phone 702-433-0800

Phyllis Rine, Assistant Administrator

Home Health:
Phyllis Rine, Assistant Administrator

Personal Care:
Jonathan Tuason, Personal Care Coordinator

Covering the counties of:

Nevada: Clark, Nye
Medical Equipment (DME) Office
Fax 708-615-0808
Phone 708-615-0800

DME:

Sandy Grummel, Administrator

Jacob Lebowicz, Field Account Manager

Robert Bicanic, Marketing Specialist
Hospice Office
Fax 630-914-5148
Phone 630-914-5140

Hospice:

Helen Lacek, LNHA Administrator

Suzanne Blanchard, MSSA, LCSW, C-ASWCM Social Worker

Rhea Gaudiano, RN, BSN Nursing Director

Covering the counties of:

Illinois: Cook, DuPage, Will