Provider Demographics
NPI:1609528447
Name:ABUNDANCE OF CARE HEALTHCARE STAFFING AGENCY LLC
Entity Type:Organization
Organization Name:ABUNDANCE OF CARE HEALTHCARE STAFFING AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:TYNAYA
Authorized Official - Middle Name:N
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:773-354-3386
Mailing Address - Street 1:OAKBROOK POINTE 700 COMMERCE DRIVE SUITE 500
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:630-229-5210
Mailing Address - Fax:630-288-4601
Practice Address - Street 1:OAKBROOK POINTE 700 COMMERCE DRIVE SUITE 500
Practice Address - Street 2:
Practice Address - City:OAKBROOK
Practice Address - State:IL
Practice Address - Zip Code:60523
Practice Address - Country:US
Practice Address - Phone:630-229-5210
Practice Address - Fax:630-288-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-24
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical Laboratory
No164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty