Healthcare Provider Details

I. General information

NPI: 1700690070
Provider Name (Legal Business Name): MIWA HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2174 GLADSTONE CT STE A
GLENDALE HEIGHTS IL
60139-1518
US

IV. Provider business mailing address

2174 GLADSTONE CT STE A
GLENDALE HEIGHTS IL
60139-1518
US

V. Phone/Fax

Practice location:
  • Phone: 847-847-4622
  • Fax:
Mailing address:
  • Phone: 847-847-4622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DIPALI PATEL
Title or Position: PRESIDENT
Credential:
Phone: 847-847-4622