Guardian Angels Homecare LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

GUARDIAN ANGELS HOMECARE LLC

Practice address

15165 State Route 73
Shannon, IL 61078-9212

Phone

(815) 662-7799

NPI assigned

Jan 14, 2025

Last updated

Jan 14, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nicole Plock

Title

Authorized Official

Phone

(815) 632-7799

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1736812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1992516546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15165 STATE ROUTE 73",
            "city": "SHANNON",
            "state": "IL",
            "postal_code": "610789212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15165 STATE ROUTE 73",
            "city": "SHANNON",
            "state": "IL",
            "postal_code": "610789212",
            "telephone_number": "815-662-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGELS HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-14",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "PLOCK",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "815-632-7799"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Lynne Byer, RN,BSN
• Brenda L Petticrew, LMT
• Shannon Fire Protection District
• Adam Zuck

• In Home Supportive Care Agency in Shannon, IL
• Providers in Shannon, IL by specialty
• In Home Supportive Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.