MEDICARE: GOOD HEART HOME CARE,INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1764072	IL

General Provider Information

NPI Number	:	1043317746
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOOD HEART HOME CARE,INC.

Provider Business Mailing Address
First Line	:	5901 N CICERO AVE STE 610
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5721
Country	:	US
Telephone Number	:	847-635-0500
Fax Number	:	847-635-7341

Provider Business Practice Location Address
First Line	:	5901 N CICERO AVE STE 610
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5721
Country	:	US
Telephone Number	:	847-635-0500
Fax Number	:	847-635-7341

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BERNADETTE DAHILIG PINGUE
Credential	:
Telephone Number	:	847-635-0500

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	11/07/2022

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