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NPI Code Detail

MEDICARE: COMPREHENSIVE QUALITY CARE INC FOUNDATION

MEDICARE: COMPREHENSIVE QUALITY CARE INC FOUNDATION
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
1253Z00000XIn Home Supportive Care Agency
2251E00000XHome Health Agency1010238IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508805938
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPREHENSIVE QUALITY CARE INC FOUNDATION
Provider Business Mailing Address
First Line : 3517 SOUTH MARTIN LUTHER KING DR.
Second Line :
City : CHICAGO
State : IL
Zip : 60653
Country : UM
Telephone Number : 773-924-5900
Fax Number : 773-924-5933
Provider Business Practice Location Address
First Line : 3517 S KING DR
Second Line :
City : CHICAGO
State : IL
Zip : 60653-3395
Country : US
Telephone Number : 773-924-5900
Fax Number : 773-924-5933
Authorized Official
Title or Position : PRESIDENT &CEO
Name : DR. JOHN M TAR
Credential : PHD
Telephone Number : 773-924-5900
Provider Enumeration Date : 06/04/2006
Last Update Date : 01/27/2017

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