Provider Demographics
NPI:1780024760
Name:ABEQUA HOME HEALTH CARE AGENCY, LLC
Entity Type:Organization
Organization Name:ABEQUA HOME HEALTH CARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGELOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-696-2868
Mailing Address - Street 1:380 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 320-B
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2290
Mailing Address - Country:US
Mailing Address - Phone:630-696-2868
Mailing Address - Fax:
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:SUITE 320-B
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:630-696-2868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care