MEDICARE: CARDIO-CARE 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	1001361	IL

General Provider Information

NPI Number	:	1164423661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIO-CARE INC

Provider Business Mailing Address
First Line	:	5917 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3728
Country	:	US
Telephone Number	:	773-989-8117
Fax Number	:	773-989-8094

Provider Business Practice Location Address
First Line	:	5917 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3728
Country	:	US
Telephone Number	:	773-989-8117
Fax Number	:	773-989-8094

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	BARBARA S COOPER
Credential	:
Telephone Number	:	773-989-8117

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	06/29/2009

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