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General NPI Number Information
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NPI Number | 1881787406
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Entity Type | Organization
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Legal Business Name | ANGEL CARE, INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4004 N NASHVILLE AVE
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-286-3211
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Fax | 773-286-2698
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Provider Business Mailing Address
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Address Line | 4004 N NASHVILLE AVE
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City | CHICAGO
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State | IL
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Zip | 60634
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Country | US
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Telephone | 773-286-3211
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Fax | 773-286-2698
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Authorized Official
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Title or Position | DON
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Name | MRS. CARMENCITA AGNO
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Credential | RN
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Telephone | 773-286-3211
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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 | 1009000
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License Number State | IL
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