Provider Demographics
NPI:1962782995
Name:ANGELS GRACE HOSPICE, LLC
Entity type:Organization
Organization Name:ANGELS GRACE HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ZRAZIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-259-4716
Mailing Address - Street 1:440 QUADRANGLE DRIVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440
Mailing Address - Country:US
Mailing Address - Phone:888-444-8341
Mailing Address - Fax:630-633-6367
Practice Address - Street 1:440 QUADRANGLE DRIVE
Practice Address - Street 2:SUITE G
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440
Practice Address - Country:US
Practice Address - Phone:888-444-8341
Practice Address - Fax:630-633-6367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-22
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based