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General NPI Number Information
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NPI Number | 1720313851
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Entity Type | Organization
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Legal Business Name | ICARE HOME HEALTH PROVIDERS, LLC
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Dates
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Enumeration Date | 10/07/2009
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 4836 MAIN ST
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City | SKOKIE
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State | IL
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Zip | 60077-2594
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Country | US
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Telephone | 847-745-8424
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Fax | 847-410-2795
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Provider Business Mailing Address
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Address Line | 4836 MAIN ST
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City | SKOKIE
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State | IL
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Zip | 60077-2594
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Country | US
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Telephone | 847-745-8424
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Fax | 847-410-2795
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Authorized Official
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Title or Position | ADMINISTRATOR/AGENCY SUPERVISOR
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Name | MS. EVELYN L BARRERA
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Credential | RN
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Telephone | 847-745-8424
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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 | 02691752
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License Number State | IL
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