NPI Code Details Logo

NPI 1225821028

NPI 1225821028 : ANGIE HEALTHCARE LLC : CHICAGO, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1225821028
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ANGIE HEALTHCARE LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/24/2025
-----------------------------------------------------
    Last Update Date     |    05/24/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8834 S BURLEY AVE APT B 
-----------------------------------------------------
    City                 |    CHICAGO
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60617-3436
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    312-788-4463
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    8834 S BURLEY AVE APT B 
-----------------------------------------------------
    City                 |    CHICAGO
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60617-3436
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    312-788-4463
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO
-----------------------------------------------------
    Name                 |     ANGELA MARIE GARDNER 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    312-788-4463
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    253Z00000X
-----------------------------------------------------
    Taxonomy Name        |    In Home Supportive Care Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    343900000X
-----------------------------------------------------
    Taxonomy Name        |    Non-emergency Medical Transport (VAN)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    385H00000X
-----------------------------------------------------
    Taxonomy Name        |    Respite Care
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
    Taxonomy Code        |    251E00000X
-----------------------------------------------------
    Taxonomy Name        |    Home Health Agency
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.