Provider Demographics
NPI:1336198480
Name:ADVANCED HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ADVANCED HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/DON
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZISERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BS
Authorized Official - Phone:847-803-6993
Mailing Address - Street 1:380 E NORTHWEST HWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2290
Mailing Address - Country:US
Mailing Address - Phone:847-803-6993
Mailing Address - Fax:847-803-6995
Practice Address - Street 1:380 E NORTHWEST HWY
Practice Address - Street 2:SUITE 350
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2290
Practice Address - Country:US
Practice Address - Phone:847-803-6993
Practice Address - Fax:847-803-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010367251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid