Provider Demographics
NPI:1699881888
Name:ADVANCE HOME HEALTH CARE, LTD.
Entity type:Organization
Organization Name:ADVANCE HOME HEALTH CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CAPAGAL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:773-850-3000
Mailing Address - Street 1:5948 N. MILWAUKEE AVE.
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646
Mailing Address - Country:US
Mailing Address - Phone:773-850-3000
Mailing Address - Fax:773-850-3001
Practice Address - Street 1:4701 N CUMBERLAND AVE
Practice Address - Street 2:SUITE 13-14
Practice Address - City:NORRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60706-2905
Practice Address - Country:US
Practice Address - Phone:708-452-1022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILIL1010282251E00000X
IL1011340251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid