Provider Demographics
NPI:1477982502
Name:WOODS, AYO
Entity Type:Individual
Prefix:
First Name:AYO
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8053 S CARPENTER ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-3035
Mailing Address - Country:US
Mailing Address - Phone:708-743-7253
Mailing Address - Fax:773-947-9471
Practice Address - Street 1:8053 S CARPENTER ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-3035
Practice Address - Country:US
Practice Address - Phone:708-743-7253
Practice Address - Fax:773-947-9471
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health