MEDICARE: QUALITY HOME CARE SERVICES LTD

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	1007038	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9951	OTHER	IL	BLUE CROSS
2	1007038	OTHER	IL	LICENSE NUMBER

General Provider Information

NPI Number	:	1720039373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY HOME CARE SERVICES LTD

Provider Business Mailing Address
First Line	:	3510 W 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-1430
Country	:	US
Telephone Number	:	773-471-0890
Fax Number	:	773-471-0280

Provider Business Practice Location Address
First Line	:	3510 W 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-1430
Country	:	US
Telephone Number	:	773-471-0890
Fax Number	:	773-471-0280

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	DR. RUDYARD U SMITH
Credential	:	M.D.
Telephone Number	:	773-471-0890

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	08/22/2020

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Directions to “QUALITY HOME CARE SERVICES LTD ” Practice Location

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