Provider Demographics
NPI:1508565300
Name:KAY'S ANGEL CARE, INC
Entity Type:Organization
Organization Name:KAY'S ANGEL CARE, INC
Other - Org Name:KAY'S ANGEL CARE, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOJISOLA KAYODE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAYODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-868-8464
Mailing Address - Street 1:1325 HOWARD ST STE 301
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3788
Mailing Address - Country:US
Mailing Address - Phone:847-868-8464
Mailing Address - Fax:847-905-0396
Practice Address - Street 1:1325 HOWARD ST STE 301
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3788
Practice Address - Country:US
Practice Address - Phone:847-868-8464
Practice Address - Fax:847-905-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL201Medicaid