Provider Demographics
NPI:1386776540
Name:A&S HOME HEALTHCARE, INC.
Entity type:Organization
Organization Name:A&S HOME HEALTHCARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SURTI
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, MBBS
Authorized Official - Phone:630-964-6100
Mailing Address - Street 1:6900 MAIN ST
Mailing Address - Street 2:SUITE# 200
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-3454
Mailing Address - Country:US
Mailing Address - Phone:630-964-6100
Mailing Address - Fax:630-964-6440
Practice Address - Street 1:6900 MAIN ST
Practice Address - Street 2:SUITE# 200
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60516-3454
Practice Address - Country:US
Practice Address - Phone:630-964-6100
Practice Address - Fax:630-964-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL1010705251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1010705OtherSTATE LICENCE NUMBER
IL147981Medicare Oscar/Certification