MEDICARE: HEALTHCARE PARTNERS AT HOME, 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1011047	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1114948254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE PARTNERS AT HOME, LLC

Provider Business Mailing Address
First Line	:	6316 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1204
Country	:	US
Telephone Number	:	773-306-5668
Fax Number	:	888-439-8416

Provider Business Practice Location Address
First Line	:	6316 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-1204
Country	:	US
Telephone Number	:	773-306-5668
Fax Number	:	888-439-8416

Authorized Official
Title or Position	:	ADMINISTRATOR/PRESIDENT
Name	:	EVAN TUBILLARA
Credential	:
Telephone Number	:	773-306-5668

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	09/26/2019

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