Organization
ANGEL HOME HEALTH AGENCY SERVICE, CORP.
Active
Other names
Angel Home Health Agency Service, Corp.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARTHA NGOZI EGIEBOR REGISTERED NURSE (ADMINISTRATOR)
(708) 410-2007
Entity
Organization
Contact information
Practice address
10001 W ROOSEVELT RD STE 308, WESTCHESTER, IL 60154-2662
(708) 410-2007
(708) 410-2017
Mailing address
10001 W ROOSEVELT RD STE 308, WESTCHESTER, IL 60154-2662
(708) 410-2007
(708) 410-2017
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1011319
IL
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011319
DEPARTMENT OF PUBLIC HEALTH
IL
Enumeration date
02/12/2011
Last updated
12/27/2022
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