# CHANGE HOMEHEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053703124
- **Authorized official:** IVORY WADDELL (CEO)
- **Authorized official phone:** (708) 668-6583

## Contact information

- **Practice address:** 3220 ADAMS ST, BELLWOOD, IL 60104-2232
- **Practice address phone:** (708) 668-6583
- **Practice address fax:** (708) 544-5677
- **Mailing address:** 3220 ADAMS ST, BELLWOOD, IL 60104-2232
- **Mailing address phone:** (708) 668-6583
- **Mailing address fax:** (708) 544-5677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | D14138856 | IL | Yes |

## Other

- **Enumeration date:** 02/26/2015
- **Last updated:** 02/26/2015