Provider Demographics
NPI:1609823046
Name:MIDWEST HEALTHCARE ASSOCIATES INC
Entity Type:Organization
Organization Name:MIDWEST HEALTHCARE ASSOCIATES INC
Other - Org Name:AMERICAN HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULFS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-236-3501
Mailing Address - Street 1:1660 N FARNSWORTH AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60505-1510
Mailing Address - Country:US
Mailing Address - Phone:630-236-3501
Mailing Address - Fax:630-236-3505
Practice Address - Street 1:1660 N FARNSWORTH AVE STE 3
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1893
Practice Address - Country:US
Practice Address - Phone:630-236-3501
Practice Address - Fax:630-236-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010268251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid
IL=========002Medicaid