Provider Demographics
NPI:1477765436
Name:ACCELERATED HOME CARE L.L.C.
Entity type:Organization
Organization Name:ACCELERATED HOME CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:TONGSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-727-4149
Mailing Address - Street 1:830 E HIGGINS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4792
Mailing Address - Country:US
Mailing Address - Phone:847-258-3630
Mailing Address - Fax:847-841-3738
Practice Address - Street 1:830 E HIGGINS RD
Practice Address - Street 2:SUITE #101
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4797
Practice Address - Country:US
Practice Address - Phone:847-258-3630
Practice Address - Fax:847-378-8439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010702251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
14-8012OtherCMS CERTIFICATION NUMBER