Organization
MIRACLE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALE MUHAMMAD RN (OWNER)
(708) 769-0196
Entity
Organization
Contact information
Practice address
2024 HICKORY RD STE 306, HOMEWOOD, IL 60430
(773) 573-9843
Mailing address
20901 CORINTH RD, OLYMPIA FIELDS, IL 60461-1872
(773) 573-9843
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
4000553
IL
251J00000X
Nursing Care Agency
Primary
4000553
IL
261QV0200X
VA Clinic/Center
4000553
IL
Other
Enumeration date
07/26/2018
Last updated
07/27/2018
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