Provider Demographics
NPI:1942566278
Name:ANGELUS HOME HEALTHCARE, INC.
Entity Type:Organization
Organization Name:ANGELUS HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AKSHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-791-9061
Mailing Address - Street 1:123 W WASHINGTON ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8214
Mailing Address - Country:US
Mailing Address - Phone:630-791-9061
Mailing Address - Fax:800-317-5711
Practice Address - Street 1:123 W WASHINGTON ST
Practice Address - Street 2:SUITE 330
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8214
Practice Address - Country:US
Practice Address - Phone:630-791-9061
Practice Address - Fax:800-317-5711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care