Healthcare Provider Details

I. General information

NPI: 1831769355
Provider Name (Legal Business Name): AMAZING CARE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18350 KEDZIE AVE STE 204
HOMEWOOD IL
60430-2759
US

IV. Provider business mailing address

18350 KEDZIE AVE STE 204
HOMEWOOD IL
60430-2759
US

V. Phone/Fax

Practice location:
  • Phone: 708-991-7868
  • Fax: 708-991-2253
Mailing address:
  • Phone: 708-991-7868
  • Fax: 708-991-2253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID EBOM
Title or Position: ADMINISTRATOR
Credential:
Phone: 708-991-7868