MEDICARE: HOMELINK HEALTHCARE, LTD

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	1010921 UNDER REVIEW	IL

General Provider Information

NPI Number	:	1134445935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMELINK HEALTHCARE, LTD

Provider Business Mailing Address
First Line	:	4747 W PETERSON AVE
Second Line	:	STE 307
City	:	CHICAGO
State	:	IL
Zip	:	60646-5712
Country	:	US
Telephone Number	:	773-930-3076
Fax Number	:	773-930-3096

Provider Business Practice Location Address
First Line	:	4747 W PETERSON AVE
Second Line	:	STE 307
City	:	CHICAGO
State	:	IL
Zip	:	60646-5712
Country	:	US
Telephone Number	:	773-930-3076
Fax Number	:	773-930-3096

Authorized Official
Title or Position	:	PRESEIDENT
Name	:	ADELBERT MONTESCLAROS
Credential	:	RPT
Telephone Number	:	312-315-9755

Provider Enumeration Date	:	04/19/2010
Last Update Date	:	04/19/2010

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