MEDICARE: ADAPTIVE NURSING AND HEALTHCARE 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	10-012100-1	IN

General Provider Information

NPI Number	:	1124257308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPTIVE NURSING AND HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	33 S STATE ST FL 5
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60603-2804
Country	:	US
Telephone Number	:	312-762-9999
Fax Number	:

Provider Business Practice Location Address
First Line	:	1502 MAGNAVOX WAY
Second Line	:	SUITE 200
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-1651
Country	:	US
Telephone Number	:	260-245-3556
Fax Number	:	260-454-2122

Authorized Official
Title or Position	:	CHIEF LEGAL OFFICER
Name	:	JOSEPH BONACCORSI
Credential	:
Telephone Number	:	312-762-9999

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	09/15/2022

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