Provider Demographics
NPI:1548570104
Name:AMAZING GRACE HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:AMAZING GRACE HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:CHIBEZE
Authorized Official - Last Name:NKEMEH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:630-988-2615
Mailing Address - Street 1:1477 SNAPDRAGON COURT
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446
Mailing Address - Country:US
Mailing Address - Phone:815-888-6496
Mailing Address - Fax:815-886-4983
Practice Address - Street 1:1477 SNAPDRAGON COURT
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446
Practice Address - Country:US
Practice Address - Phone:815-888-6496
Practice Address - Fax:815-886-4983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002251251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health