=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669606695
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VICTORIOUS HOME HEALTH CARE LIMITED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2009
-----------------------------------------------------
Last Update Date | 06/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 414 DIXIE HWY
-----------------------------------------------------
City | CHICAGO HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60411-1739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-464-9201
-----------------------------------------------------
Fax | 815-464-9202
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 414 DIXIE HWY
-----------------------------------------------------
City | CHICAGO HEIGHTS
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60411-1739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 815-464-9201
-----------------------------------------------------
Fax | 815-464-9202
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | VIRGINIA EBIRINGAH
-----------------------------------------------------
Credential | R.N
-----------------------------------------------------
Telephone | 815-464-9201
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 1010973
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------