Healthcare Provider Details

I. General information

NPI: 1730790932
Provider Name (Legal Business Name): ALL AMERICAN HEALTHCARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/11/2020
Certification Date: 08/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 211TH ST STE 2307A
MATTESON IL
60443-2349
US

IV. Provider business mailing address

4440 211TH ST STE 2307A
MATTESON IL
60443-2349
US

V. Phone/Fax

Practice location:
  • Phone: 708-890-2667
  • Fax:
Mailing address:
  • Phone: 708-890-2667
  • Fax:

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 Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MR. EDIDIONG UDOIDIONG
Title or Position: PRESIDENT
Credential:
Phone: 708-890-2667