MEDICARE: PARAGON 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	1935525	IL

General Provider Information

NPI Number	:	1578792909
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAGON HOME HEALTH INC

Provider Business Mailing Address
First Line	:	5356 N MILWAUKEE AVE
Second Line	:	1ST FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60630-1250
Country	:	US
Telephone Number	:	773-774-6601
Fax Number	:	773-774-6602

Provider Business Practice Location Address
First Line	:	5356 N MILWAUKEE AVE
Second Line	:	1ST FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60630-1250
Country	:	US
Telephone Number	:	773-774-6601
Fax Number	:	773-774-6602

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	RITZEL CARABEO DELA PENA
Credential	:	RN, BSN
Telephone Number	:	773-774-6601

Provider Enumeration Date	:	07/07/2009
Last Update Date	:	07/07/2009

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