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General NPI Number Information
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NPI Number | 1730757717
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Entity Type | Organization
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Legal Business Name | HEALTHY HEARTS HOME CARE LLC
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 2136 W 95TH ST STE 201
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City | CHICAGO
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State | IL
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Zip | 60643-1000
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Country | US
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Telephone | 773-840-3922
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Fax | 773-409-9381
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Provider Business Mailing Address
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Address Line | 6245 MICHAEL LN
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City | MATTESON
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State | IL
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Zip | 60443-2080
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Country | US
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Telephone | 773-840-3922
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ANGELA BEAL
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Credential | NP
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Telephone | 773-840-3922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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