Healthcare Provider Details

I. General information

NPI: 1801498837
Provider Name (Legal Business Name): GJ AABERG, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2020
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2407 GENERAL ELECTRIC RD STE 3
BLOOMINGTON IL
61704-3421
US

IV. Provider business mailing address

2407 GENERAL ELECTRIC RD STE 3
BLOOMINGTON IL
61704-3421
US

V. Phone/Fax

Practice location:
  • Phone: 309-808-0429
  • Fax: 309-662-2998
Mailing address:
  • Phone: 309-808-0429
  • Fax: 309-662-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: GAYE H AABERG
Title or Position: PRESIDENT
Credential:
Phone: 309-808-0429