MEDICARE: OPEN ARMS HOME HEALTH 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	1010304	IL

General Provider Information

NPI Number	:	1275532293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN ARMS HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	4001 W DEVON AVE
Second Line	:	SUITE 210
City	:	CHICAGO
State	:	IL
Zip	:	60646-4523
Country	:	US
Telephone Number	:	773-282-6272
Fax Number	:	773-282-6273

Provider Business Practice Location Address
First Line	:	4001 W DEVON AVE
Second Line	:	SUITE 210
City	:	CHICAGO
State	:	IL
Zip	:	60646-4523
Country	:	US
Telephone Number	:	773-282-6272
Fax Number	:	773-282-6273

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. NORMAN BANGALAN
Credential	:	R.N.
Telephone Number	:	773-282-6272

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	08/22/2020

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