MEDICARE: INTRINSIC HOME CARE, LLC

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		IL

General Provider Information

NPI Number	:	1073056925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTRINSIC HOME CARE, LLC

Provider Business Mailing Address
First Line	:	5113 S HARPER AVE STE 2C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4119
Country	:	US
Telephone Number	:	312-967-3177
Fax Number	:	312-924-0699

Provider Business Practice Location Address
First Line	:	5113 S HARPER AVE STE 2C
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-4119
Country	:	US
Telephone Number	:	312-967-3177
Fax Number	:	312-924-0669

Authorized Official
Title or Position	:	CEO
Name	:	DR. JASMINE C BANKHEAD
Credential	:
Telephone Number	:	312-967-3177

Provider Enumeration Date	:	11/27/2016
Last Update Date	:	07/05/2022

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