Healthcare Provider Details

I. General information

NPI: 1225829310
Provider Name (Legal Business Name): MAGDALENE MOTUBA ILONDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 PENNSYLVANIA AVE SE STE 210
WASHINGTON DC
20003-4344
US

IV. Provider business mailing address

5024 TOWNSEND WAY APT B4
BLADENSBURG MD
20710-1876
US

V. Phone/Fax

Practice location:
  • Phone: 202-282-3004
  • Fax:
Mailing address:
  • Phone: 830-375-3572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberA200004933
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: