Provider Demographics
NPI:1457489668
Name:ADVANCED PROFESSIONALS HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ADVANCED PROFESSIONALS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:CHUA
Authorized Official - Last Name:MINCHESKI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:877-771-0197
Mailing Address - Street 1:440 W BOUGHTON RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1892
Mailing Address - Country:US
Mailing Address - Phone:877-771-0197
Mailing Address - Fax:630-771-0190
Practice Address - Street 1:440 W BOUGHTON RD
Practice Address - Street 2:SUITE D
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1892
Practice Address - Country:US
Practice Address - Phone:877-771-0197
Practice Address - Fax:630-771-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1010601OtherIDPH LICENSE