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Organization

ADVANCE HOME HEALTH CARE PROVIDER CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIR M MIRJAT (ADMINISTRATOR)
(630) 424-9400
Entity
Organization

Contact information

Practice address
935 W 175TH STREET, SUITE 102, HOMEWOOD, IL 60430
(630) 424-9400
(630) 424-9421
Mailing address
935 W 175TH STREET, SUITE 102, HOMEWOOD, IL 60430
(630) 424-9400
(630) 424-9421

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IL1010800
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
IL1010800
IDPH
IL
Enumeration date
10/06/2007
Last updated
10/28/2019
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