MEDICARE: ATTENTIVE CARE HOME HEALTH 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	10111542	IL

General Provider Information

NPI Number	:	1417293176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATTENTIVE CARE HOME HEALTH INC.

Provider Business Mailing Address
First Line	:	2242 OGDEN AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7218
Country	:	US
Telephone Number	:	630-566-7155
Fax Number	:	630-608-6856

Provider Business Practice Location Address
First Line	:	2242 OGDEN AVE
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7218
Country	:	US
Telephone Number	:	630-566-7155
Fax Number	:	630-608-6856

Authorized Official
Title or Position	:	ASSISTANT ADMINISTRATOR
Name	:	ROBERT LACKEY
Credential	:
Telephone Number	:	630-566-7155

Provider Enumeration Date	:	12/27/2012
Last Update Date	:	12/27/2012

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