Healthcare Provider Details

I. General information

NPI: 1114009222
Provider Name (Legal Business Name): ACCESS HEALTH MEDICAL SUPPLIES AND HOME HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 W 95TH ST
CHICAGO IL
60643-1001
US

IV. Provider business mailing address

2215 W 95TH ST
CHICAGO IL
60643-1001
US

V. Phone/Fax

Practice location:
  • Phone: 773-221-4273
  • Fax: 773-221-4565
Mailing address:
  • Phone: 773-221-4273
  • Fax: 773-221-4565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL ILOEGBUNAM
Title or Position: ADMINISTRATOR
Credential:
Phone: 773-221-4273