1447367800 NPI number — ADVANTA HOME HEALTH CARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447367800 NPI number — ADVANTA HOME HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANTA HOME HEALTH CARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447367800
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 W FRONTAGE RD STE 3700
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60093-1221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-504-0888
Provider Business Mailing Address Fax Number:
847-504-0887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 W FRONTAGE RD STE 3700
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60093-1221
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-504-0888
Provider Business Practice Location Address Fax Number:
847-504-0887
Provider Enumeration Date:
08/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KOSHEV
Authorized Official First Name:
NATALY
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
847-504-0888

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1010489 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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