Healthcare Provider Details

I. General information

NPI: 1174449664
Provider Name (Legal Business Name): NEW ANGLE HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8454 S WOLCOTT AVE
CHICAGO IL
60620-4751
US

IV. Provider business mailing address

8454 S WOLCOTT AVE
CHICAGO IL
60620-4751
US

V. Phone/Fax

Practice location:
  • Phone: 708-513-1168
  • Fax:
Mailing address:
  • Phone: 708-513-1168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SEDRICK MICKEY
Title or Position: MANAGER
Credential:
Phone: 708-513-1168