Healthcare Provider Details

I. General information

NPI: 1508912379
Provider Name (Legal Business Name): ACE HEALTH CENTER, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E IRVING PARK RD
WOOD DALE IL
60191-2045
US

IV. Provider business mailing address

203 E IRVING PARK RD
WOOD DALE IL
60191-2045
US

V. Phone/Fax

Practice location:
  • Phone: 847-385-0700
  • Fax: 847-398-4585
Mailing address:
  • Phone: 847-385-0700
  • Fax: 877-550-1717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number042618214
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number042618214
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number042618214
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number042618214
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number042618214
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number042618214
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number042618214
License Number StateIL
# 8
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number042618214
License Number StateIL
# 9
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number042618214
License Number StateIL

VIII. Authorized Official

Name: DALIA ZAMBRANO
Title or Position: BILLING MANAGER
Credential:
Phone: 847-358-0700