Provider Demographics
NPI:1326233693
Name:ADVANCE HOME HEALTH , INC.
Entity Type:Organization
Organization Name:ADVANCE HOME HEALTH , INC.
Other - Org Name:ADVANCE CARE AND INFUSION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONDAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-545-0179
Mailing Address - Street 1:800 ROOSEVELT RD
Mailing Address - Street 2:BLDG. A, SUITE 212
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-5839
Mailing Address - Country:US
Mailing Address - Phone:630-545-0179
Mailing Address - Fax:630-545-0208
Practice Address - Street 1:800 ROOSEVELT RD
Practice Address - Street 2:BLDG. A, SUITE 212
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-5839
Practice Address - Country:US
Practice Address - Phone:630-545-0179
Practice Address - Fax:630-545-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010783251E00000X, 251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion