Organization
VINTAGE HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENO AKANO (DIRECTOR)
(630) 517-0191
Entity
Organization
Contact information
Practice address
7 BLANCHARD CIR, SUITE 103, WHEATON, IL 60189-2037
(630) 517-0191
(630) 260-1035
Mailing address
7 BLANCHARD CIR, SUITE 103, WHEATON, IL 60189-2037
(630) 517-0191
(630) 260-1035
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
4000250
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010816
—
IL
Enumeration date
07/20/2012
Last updated
07/20/2012
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