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General NPI Number Information
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NPI Number | 1043266083
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Entity Type | Organization
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Legal Business Name | ACCUCARE HOME HEALTH SERVICES INC.
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 01/08/2008
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Provider Practice Location Address
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Address Line | 1027 OGDEN AVE
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City | LISLE
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State | IL
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Zip | 60532-1341
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Country | US
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Telephone | 630-963-8862
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Fax | 630-963-8892
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Provider Business Mailing Address
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Address Line | 1027 OGDEN AVE
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City | LISLE
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State | IL
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Zip | 60532-1341
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Country | US
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Telephone | 630-963-8862
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Fax | 630-963-8892
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. AMY R MEDINA
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Credential | BSBA
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Telephone | 630-963-8862
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IL1010565
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License Number State | IL
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