Provider Demographics
NPI:1700964855
Name:AVESENA INC.
Entity Type:Organization
Organization Name:AVESENA INC.
Other - Org Name:AVESENA HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:630-833-2486
Mailing Address - Street 1:221 E LAKE ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2888
Mailing Address - Country:US
Mailing Address - Phone:630-833-2486
Mailing Address - Fax:630-833-2487
Practice Address - Street 1:221 E LAKE ST
Practice Address - Street 2:SUITE 108
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2888
Practice Address - Country:US
Practice Address - Phone:630-833-2486
Practice Address - Fax:630-833-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1010340OtherSTATE ID
ILIL1010340OtherSTATE ID