Provider Demographics
NPI:1215274972
Name:ACE HOME HEALTH PROVIDER INC
Entity type:Organization
Organization Name:ACE HOME HEALTH PROVIDER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-685-6000
Mailing Address - Street 1:5901 N CICERO AVE STE G3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5711
Mailing Address - Country:US
Mailing Address - Phone:773-685-6000
Mailing Address - Fax:773-770-4754
Practice Address - Street 1:5901 N CICERO AVE STE G3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5711
Practice Address - Country:US
Practice Address - Phone:773-685-6000
Practice Address - Fax:773-770-4754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011572251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health