Healthcare Provider Details

I. General information

NPI: 1558752568
Provider Name (Legal Business Name): ALPHA HEALTH CARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 ARONOMINK CIR
ELGIN IL
60123-6838
US

IV. Provider business mailing address

2000 ARONOMINK CIR
ELGIN IL
60123-6838
US

V. Phone/Fax

Practice location:
  • Phone: 847-983-8356
  • Fax: 888-909-5815
Mailing address:
  • Phone: 847-983-8356
  • Fax: 888-909-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: CONRADO CRUZ
Title or Position: PRESIDENT
Credential:
Phone: 847-983-8356