MEDICARE: MG ROHAN, 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	253Z00000X	In Home Supportive Care Agency	3000134	IL

General Provider Information

NPI Number	:	1730622796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MG ROHAN, INC.

Provider Business Mailing Address
First Line	:	930 N YORK RD
Second Line	:	SUITE 150
City	:	HINSDALE
State	:	IL
Zip	:	60521-2991
Country	:	US
Telephone Number	:	630-920-9999
Fax Number	:	630-920-8453

Provider Business Practice Location Address
First Line	:	930 N YORK RD
Second Line	:	SUITE 150
City	:	HINSDALE
State	:	IL
Zip	:	60521-2991
Country	:	US
Telephone Number	:	630-920-9999
Fax Number	:	630-920-8453

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	MR. MICHAEL ROHAN
Credential	:
Telephone Number	:	630-920-9999

Provider Enumeration Date	:	11/23/2016
Last Update Date	:	11/23/2016

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