MEDICARE: ESSEX HOME HEALTH SERVICES 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	251E00000X	Home Health Agency	1011724	IL

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
2	5435	OTHER	IL	HOME HEALTH CARE

General Provider Information

NPI Number	:	1093771917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSEX HOME HEALTH SERVICES INC.

Provider Business Mailing Address
First Line	:	8018 S ESSEX AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-1221
Country	:	US
Telephone Number	:	773-933-0494
Fax Number	:	773-933-0528

Provider Business Practice Location Address
First Line	:	8018 S ESSEX AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-1221
Country	:	US
Telephone Number	:	773-933-0494
Fax Number	:	773-933-0528

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MR. DEANGELO GRIFFIN
Credential	:
Telephone Number	:	773-933-0494

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	06/05/2014

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