Provider Demographics
NPI:1457623340
Name:OVINE HOMEHEALTH, INC.
Entity type:Organization
Organization Name:OVINE HOMEHEALTH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZUBUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-622-4141
Mailing Address - Street 1:1900 N AUSTIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-5010
Mailing Address - Country:US
Mailing Address - Phone:773-622-4141
Mailing Address - Fax:
Practice Address - Street 1:1900 N AUSTIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-5010
Practice Address - Country:US
Practice Address - Phone:773-622-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-07
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011392251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health