1619059813 NPI number — ABBA 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 1619059813 NPI number — ABBA HOME HEALTH CARE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABBA 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:
1619059813
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6677 N LINCOLN AVE
Provider Second Line Business Mailing Address:
SUITE 430
Provider Business Mailing Address City Name:
LINCOLNWOOD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60712-3619
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-679-7200
Provider Business Mailing Address Fax Number:
847-679-7201

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6677 N LINCOLN AVE
Provider Second Line Business Practice Location Address:
SUITE 430
Provider Business Practice Location Address City Name:
LINCOLNWOOD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60712-3619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-679-7200
Provider Business Practice Location Address Fax Number:
847-679-7201
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NAJAMUDDIN
Authorized Official First Name:
MOHAMMED
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-679-7200

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  1010426 , 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)

  • Identifier: 1010426 . This is a "IDPH LICENSE" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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