Healthcare Provider Details

I. General information

NPI: 1174534333
Provider Name (Legal Business Name): NOS HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4N150 WOOD DALE RD
ADDISON IL
60101-2965
US

IV. Provider business mailing address

4N150 WOOD DALE RD
ADDISON IL
60101-2965
US

V. Phone/Fax

Practice location:
  • Phone: 630-941-3683
  • Fax: 630-501-0958
Mailing address:
  • Phone: 630-941-3683
  • Fax: 630-501-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1008283
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1008283
Identifier TypeOTHER
Identifier StateIL
Identifier IssuerSTATE LICENSE NUMBER

VIII. Authorized Official

Name: MS. NORMA STAVROPOULOS
Title or Position: ADMINISTRATOR
Credential:
Phone: 630-941-3683