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General NPI Number Information
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NPI Number | 1558621623
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Entity Type | Organization
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Legal Business Name | AMAZING HOME HEALTH SERVICES, INC
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Dates
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Enumeration Date | 05/23/2012
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Last Update Date | 05/23/2012
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Provider Practice Location Address
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Address Line | 6833 S WABASH AVE
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City | CHICAGO
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State | IL
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Zip | 60637-3911
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Country | US
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Telephone | 773-488-3411
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Fax | 773-488-3414
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Provider Business Mailing Address
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Address Line | 6833 S WABASH AVE 70 W. MADISON ST. SUITE 1406
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City | CHICAGO
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State | IL
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Zip | 60637-3911
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Country | US
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Telephone | 773-488-3411
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Fax | 773-488-3414
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Authorized Official
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Title or Position | PRESIDENT
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Name | CLARISSA MITCHELL
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Credential |
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Telephone | 773-818-2657
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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 | 2129758
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License Number State | IL
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