Healthcare Provider Details

I. General information

NPI: 1649532979
Provider Name (Legal Business Name): AGA CARE CONNECT HOME HEALTH AGENCY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 06/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21141 GOVERNORS HWY SUITE 201
MATTESON IL
60443-3801
US

IV. Provider business mailing address

21141 GOVERNORS HWY SUITE 201
MATTESON IL
60443-3801
US

V. Phone/Fax

Practice location:
  • Phone: 708-898-0502
  • Fax: 708-898-0503
Mailing address:
  • Phone: 708-898-0502
  • Fax: 708-898-0503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. ABIGAIL UZOARU-ISEWEDE
Title or Position: CHIEF OFFICER
Credential: RN
Phone: 708-647-0034