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General NPI Number Information
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NPI Number | 1104058346
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Entity Type | Organization
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Legal Business Name | ABC HOME HEALTH CARE, INC
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Dates
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Enumeration Date | 08/21/2009
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Last Update Date | 09/16/2011
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Provider Practice Location Address
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Address Line | 6314 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-4706
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Country | US
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Telephone | 773-581-0888
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Fax | 773-581-8048
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Provider Business Mailing Address
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Address Line | 6314 S PULASKI RD
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City | CHICAGO
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State | IL
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Zip | 60629-4706
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Country | US
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Telephone | 773-581-0888
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Fax | 773-581-8048
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HAITHAM RAMADAN
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Credential | PHYSICAL THERAPIST
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Telephone | 773-581-0888
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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 | 1011472
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License Number State | IL
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