Provider Demographics
NPI:1447569488
Name:ANGEL HEALTH CARE LLC
Entity Type:Organization
Organization Name:ANGEL HEALTH CARE LLC
Other - Org Name:ABSOLUTE HOME WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEGENER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-510-5905
Mailing Address - Street 1:2325 DEAN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60175-4810
Mailing Address - Country:US
Mailing Address - Phone:847-510-5905
Mailing Address - Fax:630-345-3233
Practice Address - Street 1:2325 DEAN ST STE 400
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60175-4810
Practice Address - Country:US
Practice Address - Phone:847-510-5905
Practice Address - Fax:630-345-3233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011320251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health