MEDICARE: FRANCES HOUSE 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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

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

General Provider Information

NPI Number	:	1962828004
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRANCES HOUSE INC

Provider Business Mailing Address
First Line	:	1504 16TH ST
Second Line	:
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-2001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 16TH ST
Second Line	:
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-2001
Country	:	US
Telephone Number	:	309-343-1550
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED AGENT
Name	:	RONALD J WILSON
Credential	:
Telephone Number	:	309-343-1550

Provider Enumeration Date	:	03/13/2014
Last Update Date	:	03/13/2014

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Directions to “FRANCES HOUSE INC ” Practice Location

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