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General NPI Number Information
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NPI Number | 1154507226
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Entity Type | Organization
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Legal Business Name | ANGEL TOUCH HOME HEALTHCARE, INC.
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Dates
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Enumeration Date | 01/18/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 5757 N LINCOLN AVE STE 18
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City | CHICAGO
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State | IL
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Zip | 60659-4729
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Country | US
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Telephone | 773-907-0300
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Fax | 773-907-0325
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Provider Business Mailing Address
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Address Line | 5757 N LINCOLN AVE STE 18
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City | CHICAGO
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State | IL
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Zip | 60659-4729
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Country | US
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Telephone | 773-907-0300
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Fax | 773-907-0325
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Authorized Official
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Title or Position | ASSISTANT ADM./ PRESIDENT
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Name | MR. SOFRONIO C. RAVAGO
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Credential | ENGINEER
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Telephone | 773-907-0300
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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 | 1010730
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License Number State | IL
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