Healthcare Provider Details

I. General information

NPI: 1376817726
Provider Name (Legal Business Name): ADVOCATE HOME HEALTHCARE AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2012
Last Update Date: 03/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 SHEPARD DR 17B
ELGIN IL
60123-7033
US

IV. Provider business mailing address

450 SHEPARD DR 17B
ELGIN IL
60123-7033
US

V. Phone/Fax

Practice location:
  • Phone: 847-608-1800
  • Fax: 847-608-1820
Mailing address:
  • Phone: 847-608-1800
  • Fax: 847-608-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1011422
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number4000336
License Number StateIL

VIII. Authorized Official

Name: ANGELA C VALENTINO
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 847-608-1800