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General NPI Number Information
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NPI Number | 1114698578
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Entity Type | Organization
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Legal Business Name | ULTRA HOME HEALTHCARE INC
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 5901 N CICERO AVE STE 309
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City | CHICAGO
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State | IL
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Zip | 60646-5719
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Country | US
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Telephone | 773-657-3728
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Fax | 773-492-7456
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Provider Business Mailing Address
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Address Line | 5901 N CICERO AVE STE 205
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City | CHICAGO
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State | IL
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Zip | 60646-5718
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Country | US
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Telephone | 773-657-3728
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Fax | 773-492-6617
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. OMOLOLA ASIELUE
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Credential |
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Telephone | 773-657-3728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number |
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License Number State |
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