Provider Demographics
NPI:1366752529
Name:MEDICAL ADVOCATE HEALTHCARE SERVICES CORP
Entity type:Organization
Organization Name:MEDICAL ADVOCATE HEALTHCARE SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:DE GUZMAN
Authorized Official - Last Name:MAGLAQUE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:224-715-2534
Mailing Address - Street 1:5305 N. LUNA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630
Mailing Address - Country:US
Mailing Address - Phone:773-936-9695
Mailing Address - Fax:847-548-2650
Practice Address - Street 1:5305 N. LUNA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630
Practice Address - Country:US
Practice Address - Phone:773-936-9695
Practice Address - Fax:847-548-2650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health