Provider Demographics
NPI:1154795060
Name:ANGEL CAREGIVERS INC.
Entity type:Organization
Organization Name:ANGEL CAREGIVERS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAI
Authorized Official - Middle Name:
Authorized Official - Last Name:ICAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-954-8628
Mailing Address - Street 1:7415 W FOSTER AVE
Mailing Address - Street 2:
Mailing Address - City:HARWOOD HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60706-3451
Mailing Address - Country:US
Mailing Address - Phone:708-585-0525
Mailing Address - Fax:847-867-7145
Practice Address - Street 1:7415 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:HARWOOD HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60706-3451
Practice Address - Country:US
Practice Address - Phone:708-585-0525
Practice Address - Fax:847-867-7145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health