Provider Demographics
NPI:1033424056
Name:AWESOME HOME HEALTH CARE,INC.
Entity Type:Organization
Organization Name:AWESOME HOME HEALTH CARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IKRAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ULLH
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED PT
Authorized Official - Phone:773-840-3386
Mailing Address - Street 1:10540 S WESTERN AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-2536
Mailing Address - Country:US
Mailing Address - Phone:773-840-3386
Mailing Address - Fax:773-840-3127
Practice Address - Street 1:10540 S WESTERN AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-2536
Practice Address - Country:US
Practice Address - Phone:773-840-3386
Practice Address - Fax:773-840-3127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-13
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011318251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health