Organization
ABUNDANT HOME HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL UDONKANG (ADMINISTRATOR)
(815) 932-1600
Entity
Organization
Contact information
Practice address
19 HERITAGE DR STE 102, BOURBONNAIS, IL 60914-1369
(815) 932-1600
(815) 932-1602
Mailing address
19 HERITAGE PLAZA SUITE102, BOURBONNAIS, IL 60914-1369
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011754
ILLINOIS DEPARTMENT OF PUBLIC HEALTH LICENSE FOR AGENCY
IL
Enumeration date
10/20/2010
Last updated
09/01/2016
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