1972541449 NPI number — EXCEL HEALTH CARE, INC.

Table of content: (NPI 1972541449)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972541449 NPI number — EXCEL HEALTH CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EXCEL 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:
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:
1972541449
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/19/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 PAYSPHERE CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60674-0019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-879-6137
Provider Business Mailing Address Fax Number:
847-913-9024

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4170 LAFAYETTE CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
CHANTILLY
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20151-1254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-471-8200
Provider Business Practice Location Address Fax Number:
703-471-8205
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BONACCORSI
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
Authorized Official Title or Position:
SR VP, SECRETARY & GENERAL COUNSEL
Authorized Official Telephone Number:
847-229-7794

Provider Taxonomy Codes

  • Taxonomy code: 332BP3500X , with the licence number:  0201003388 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QI0500X , with the licence number: 0201003388 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336S0011X , with the licence number: 0201003388 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336H0001X , with the licence number: 0201003388 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8508879 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9114637 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com