Provider Demographics
NPI:1275131419
Name:FOATEX HEALTH CILACARE
Entity Type:Organization
Organization Name:FOATEX HEALTH CILACARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:O
Authorized Official - Last Name:AGOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, PHD
Authorized Official - Phone:773-556-9600
Mailing Address - Street 1:4219 179TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4714
Mailing Address - Country:US
Mailing Address - Phone:773-556-9600
Mailing Address - Fax:708-326-2121
Practice Address - Street 1:823 163RD ST
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5915
Practice Address - Country:US
Practice Address - Phone:773-556-9600
Practice Address - Fax:708-326-2121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-10
Last Update Date:2020-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities