1023011079 NPI number — ADVANTAGE HOME HEALTH CARE, INC.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:	ADVANTAGE HOME HEALTH CARE, INC.
Provider Last Name (Legal Name)	:
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NPI Number	:	1023011079
Entity Type Code	:	Organization
Replacement NPI	:
Last Update Date	:	07/08/2007
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Provider First Line Business Mailing Address	:	23950 S NORTHERN ILLINOIS DR
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	CHANNAHON
Provider Business Mailing Address State Name	:	IL
Provider Business Mailing Address Postal Code	:	604105184
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	8154671905
Provider Business Mailing Address Fax Number	:	8154676392

Provider First Line Business Practice Location Address	:	23950 S NORTHERN ILLINOIS DR
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	CHANNAHON
Provider Business Practice Location Address State Name	:	IL
Provider Business Practice Location Address Postal Code	:	604105184
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	8154671905
Provider Business Practice Location Address Fax Number	:	8154676392
Provider Enumeration Date	:	05/23/2005

Authorized Official Last Name	:	WELTER
Authorized Official First Name	:	SHARON
Authorized Official Middle Name	:	A
Authorized Official Title or Position	:	DIRECTOR
Authorized Official Telephone Number	:	8154671905

• Taxonomy code: 251E00000X , with the licence number:  1008614 , registered in the state of IL .

• Identifier: 147644 , issued by the state of ( IL ) . This identifiers is of the category "".