Organization
PRO ACTIVE HEALTH SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARIFFA HANNA F. MOHAMMAD B.S.N. R.N. (DIRECTOR OF NURSING)
(773) 507-6464
Entity
Organization
Contact information
Practice address
4350 OAKTON STREET, SUITE 206, SKOKIE, IL 60076-3270
(773) 507-6464
Mailing address
4350 OAKTON ST, SUITE 206, SKOKIE, IL 60076-3270
(773) 507-6464
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
TAXONOMY CODE FOR NURSING
IL
Enumeration date
04/06/2011
Last updated
10/17/2012
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