1013225788 NPI number — ADVOCATE HOME HEALTH CARE AND WELLNESS COUNCIL, 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 1013225788 NPI number — ADVOCATE HOME HEALTH CARE AND WELLNESS COUNCIL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCATE HOME HEALTH CARE AND WELLNESS COUNCIL, 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:
6
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:
1013225788
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18430 S HALSTED ST
Provider Second Line Business Mailing Address:
202
Provider Business Mailing Address City Name:
GLENWOOD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60425-1013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-617-8871
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18430 S HALSTED ST
Provider Second Line Business Practice Location Address:
202
Provider Business Practice Location Address City Name:
GLENWOOD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60425-1013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-617-8871
Provider Business Practice Location Address Fax Number:
708-617-8871
Provider Enumeration Date:
09/16/2010

Additional Information

Authorized Official

Authorized Official Last Name:
HAGAN
Authorized Official First Name:
LOLITA
Authorized Official Middle Name:
INEZ
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
708-617-8871

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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