Active NPI
Angie McCulloch
- Adult Companion
- Elk Grove Village, IL
National Provider Identifier
1124686423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- 3000242
- Practice address
- 450 E Higgins Rd Ste 102
Elk Grove Village, IL 60007-1417 - Phone
- (847) 690-9825
- Fax
- (847) 690-9824
- NPI assigned
- May 31, 2019
- Last updated
- May 31, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Companion | 372600000X | 3000242 | IL | Primary |
Addresses
Primary practice location
450 E Higgins Rd Ste 102
Elk Grove Village, IL 60007-1417
Mailing address
450 E Higgins Rd Ste 102
Elk Grove Village, IL 60007-1417
Phone (847) 690-9825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3000242 | IL | MD | Adult Companion |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hutchison Enterprises, Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Home Instead Senior Care 205
- In Home Supportive Care Agency
- Elk Grove Village, IL
- NPI 1306398623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559260800000",
"number": "1124686423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 E HIGGINS RD STE 102",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600071417",
"telephone_number": "847-690-9825",
"fax_number": "847-690-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 E HIGGINS RD STE 102",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600071417",
"telephone_number": "847-690-9825",
"fax_number": "847-690-9824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCULLOCH",
"first_name": "ANGIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-31",
"last_updated": "2019-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "IL",
"license": "3000242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.