Healthcare Provider Details

I. General information

NPI: 1942023429
Provider Name (Legal Business Name): AMARA HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 N LINCOLN AVE
CHICAGO IL
60659-4672
US

IV. Provider business mailing address

269 NORWAY CT
BARTLETT IL
60103-2106
US

V. Phone/Fax

Practice location:
  • Phone: 419-494-4268
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: CHINEDU OGUEJIOFOR
Title or Position: MANAGER
Credential:
Phone: 419-494-4268