Provider Demographics
NPI:1023011079
Name:ADVANTAGE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ADVANTAGE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SLEETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-467-1905
Mailing Address - Street 1:425 E. US RT. 6
Mailing Address - Street 2:SUITE F
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-8812
Mailing Address - Country:US
Mailing Address - Phone:815-467-1905
Mailing Address - Fax:815-467-6392
Practice Address - Street 1:425 E. US RT. 6
Practice Address - Street 2:SUITE F
Practice Address - City:MORRIS
Practice Address - State:IL
Practice Address - Zip Code:60450-8812
Practice Address - Country:US
Practice Address - Phone:815-467-1905
Practice Address - Fax:815-467-6392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1008614251E00000X
IL1011673251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147644Medicare Oscar/Certification
IL147644Medicare ID - Type Unspecified