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General NPI Number Information
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NPI Number | 1992912182
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Entity Type | Organization
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Legal Business Name | ICARE HOME HEALTH CORPORATION
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 09/06/2011
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Provider Practice Location Address
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Address Line | 5962 N LINCOLN AVE SUITE 3
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City | CHICAGO
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State | IL
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Zip | 60659-3711
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Country | US
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Telephone | 773-334-2515
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Fax | 773-334-2516
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Provider Business Mailing Address
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Address Line | 5962 N LINCOLN AVE SUITE 3
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City | CHICAGO
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State | IL
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Zip | 60659-3711
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Country | US
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Telephone | 773-334-2515
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Fax | 773-334-2516
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. IRENE G AGUILA
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Credential | BSN-RN
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Telephone | 773-334-2515
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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 | 1011369
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License Number State | IL
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