Healthcare Provider Details

I. General information

NPI: 1942566278
Provider Name (Legal Business Name): ANGELUS HOME HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 W WASHINGTON ST SUITE 330
OSWEGO IL
60543-8214
US

IV. Provider business mailing address

123 W WASHINGTON ST SUITE 330
OSWEGO IL
60543-8214
US

V. Phone/Fax

Practice location:
  • Phone: 630-791-9061
  • Fax: 800-317-5711
Mailing address:
  • Phone: 630-791-9061
  • Fax: 800-317-5711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AKSHAY PATEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 630-791-9061