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General NPI Number Information
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NPI Number | 1043404023
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Entity Type | Organization
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Legal Business Name | WELLNESS HOME CARE, INC.
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Dates
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Enumeration Date | 09/01/2007
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 9415 S WESTERN AVE SUITE 109
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City | CHICAGO
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State | IL
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Zip | 60643-6700
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Country | US
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Telephone | 773-779-8815
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Fax | 773-779-8875
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Provider Business Mailing Address
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Address Line | 9415 S WESTERN AVE SUITE 109
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City | CHICAGO
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State | IL
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Zip | 60643-6700
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Country | US
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Telephone | 773-779-8815
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Fax | 773-779-8875
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FELICIA HAYES
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Credential | REGISTERED NURSE
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Telephone | 773-779-8815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010757
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License Number State | IL
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