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General NPI Number Information
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NPI Number | 1669639746
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Entity Type | Organization
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Legal Business Name | MEDICOSE HOME HEALTHCARE SVS INC
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Dates
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Enumeration Date | 05/17/2008
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Last Update Date | 08/17/2010
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Provider Practice Location Address
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Address Line | 9605 KEELER AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1127
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Country | US
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Telephone | 847-674-3240
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Fax | 847-674-3318
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Provider Business Mailing Address
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Address Line | 9605 KEELER AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1127
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Country | US
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Telephone | 847-674-3240
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Fax | 847-674-3318
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Authorized Official
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Title or Position | SECRETARY
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Name | MR. JOHN YOUSEFZAI
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Credential |
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Telephone | 847-322-5960
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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 | 1898321
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License Number State | IL
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