Healthcare Provider Details
I. General information
NPI: 1538768155
Provider Name (Legal Business Name): ANGELICARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/23/2020
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6650 N NORTHWEST HWY STE 215
CHICAGO IL
60631-1363
US
IV. Provider business mailing address
326 ELK BLVD
DES PLAINES IL
60016-3506
US
V. Phone/Fax
- Phone: 847-908-8818
- Fax: 847-908-8811
- Phone: 773-392-9103
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133NN1002X |
| Taxonomy | Nutrition Education Nutritionist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171WH0202X |
| Taxonomy | Home Modifications Contractor |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 174H00000X |
| Taxonomy | Health Educator |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 372600000X |
| Taxonomy | Adult Companion |
| License Number | |
| License Number State | |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | |
| # 14 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
ANGELIKA
DANEK
Title or Position: OWNER/ADMINISTRATOR
Credential: LCSW
Phone: 773-392-9103