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NPI Code Detail

MEDICARE: JAGEN HOME HEALTH SERVICES,INC

MEDICARE: JAGEN HOME HEALTH SERVICES,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
1251E00000XHome Health Agency1010736IL

General Provider Information

NPI Number : 1295922888
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAGEN HOME HEALTH SERVICES,INC
Provider Business Mailing Address
First Line : 5151 N HARLEM AVE STE 207
Second Line :
City : CHICAGO
State : IL
Zip : 60656-3686
Country : US
Telephone Number : 773-631-2573
Fax Number : 773-631-2593
Provider Business Practice Location Address
First Line : 5151 N HARLEM AVE STE 207
Second Line :
City : CHICAGO
State : IL
Zip : 60656-3686
Country : US
Telephone Number : 773-631-2573
Fax Number : 773-631-2593
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. MARIA CECILA PELAEZ
Credential : R.N.
Telephone Number : 773-631-2573
Provider Enumeration Date : 09/27/2007
Last Update Date : 09/27/2007

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