MEDICARE: ADVANCARE HEALTHCARE SERVICES 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	1010344	IL

General Provider Information

NPI Number	:	1548299654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCARE HEALTHCARE SERVICES LLC

Provider Business Mailing Address
First Line	:	2625 BUTTERFIELD RD
Second Line	:	304S
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1234
Country	:	US
Telephone Number	:	708-392-2000
Fax Number	:	708-392-2008

Provider Business Practice Location Address
First Line	:	2625 BUTTERFIELD RD
Second Line	:	304S
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1234
Country	:	US
Telephone Number	:	708-392-2000
Fax Number	:	708-392-2008

Authorized Official
Title or Position	:	MANAGING DIRECTOR LLC MEMBER
Name	:	MR. DONALD A JARVIS
Credential	:
Telephone Number	:	708-392-2000

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	11/07/2014

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