Healthcare Provider Details

I. General information

NPI: 1801524137
Provider Name (Legal Business Name): SABRINA JOHNSON ADVOCATE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2022
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 ROTTERDAM DR
ANTIOCH IL
60002-2621
US

IV. Provider business mailing address

69 ROTTERDAM DR
ANTIOCH IL
60002-2621
US

V. Phone/Fax

Practice location:
  • Phone: 708-691-3858
  • Fax:
Mailing address:
  • Phone: 708-691-3858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SABRINA JOHNSON
Title or Position: FOUNDER AND PRESIDENT
Credential:
Phone: 708-691-3858