NPIMap

Organization Active NPI

Advance Life Management, LLC

Doing business as Advance Lifecare Home Health

  • Home Health Agency
  • Woodridge, IL
National Provider Identifier
1902252992
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
1011767 Issued in IL
Legal business name
ADVANCE LIFE MANAGEMENT, LLC
Doing business as
Advance Lifecare Home Health
Practice address
3590 Hobson Rd
Suite 402
Woodridge, IL 60517-5409
Phone
(630) 852-5700
Fax
(630) 852-5600
NPI assigned
May 9, 2016
Last updated
May 9, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patrick Custardo, J.D.
Title
Administrator
Phone
(630) 852-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 1011767 IL Primary

Addresses

Primary practice location

3590 Hobson Rd
Suite 402
Woodridge, IL 60517-5409

Mailing address

3590 Hobson Rd
Suite 402
Woodridge, IL 60517-5409
Phone (630) 852-5700

Other names 1

  • ADVANCE LIFECARE HOME HEALTH Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462752000000",
    "number": "1902252992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "address_2": "SUITE 402",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-852-5700",
            "fax_number": "630-852-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOBSON RD",
            "address_2": "SUITE 402",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605175409",
            "telephone_number": "630-852-5700",
            "fax_number": "630-852-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE LIFE MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A",
        "authorized_official_last_name": "CUSTARDO",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "630-852-5700",
        "authorized_official_credential": "J.D."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1011767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ADVANCE LIFECARE HOME HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.