MEDICARE: DINA AHENKAN OBENEWAH AMOO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency		IL

General Provider Information

NPI Number	:	1811827611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DINA AHENKAN OBENEWAH AMOO

Provider Business Mailing Address
First Line	:	1809 POWERS RD
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-2775
Country	:	US
Telephone Number	:	81-523-6068
Fax Number	:

Provider Business Practice Location Address
First Line	:	1809 POWERS RD
Second Line	:
City	:	WOODSTOCK
State	:	IL
Zip	:	60098-2775
Country	:	US
Telephone Number	:	81-523-6068
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2026
Last Update Date	:	05/22/2026

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