1548441959 NPI number — ABILITY HEALTHCARE, LTD

Table of content: (NPI 1548441959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548441959 NPI number — ABILITY HEALTHCARE, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABILITY HEALTHCARE, LTD
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:
ASSOCIATED BACK CARE, LTD
Provider Other Organization Name Type Code:
4
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:
1548441959
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1100 LAKE STREET
Provider Second Line Business Mailing Address:
SUITE 120
Provider Business Mailing Address City Name:
OAK PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-848-8488
Provider Business Mailing Address Fax Number:
708-848-8480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1100 LAKE STREET
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
OAK PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-848-8488
Provider Business Practice Location Address Fax Number:
708-848-8480
Provider Enumeration Date:
11/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PIRIE
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
708-848-8488

Provider Taxonomy Codes

  • Taxonomy code: 111NN1001X , with the licence number:  038007140 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111NR0400X , with the licence number: 038007140 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225700000X , with the licence number: 038007140 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01619002 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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