MEDICARE: ACCORD 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	IL1010461	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IL1010461	OTHER	IL	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1205874005
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCORD HOME HEALTH SERVICES, INC.

Provider Business Mailing Address
First Line	:	6871 171ST ST
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-3447
Country	:	US
Telephone Number	:	708-481-6604
Fax Number	:

Provider Business Practice Location Address
First Line	:	6871 171ST ST
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-3447
Country	:	US
Telephone Number	:	708-481-6604
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. PRISCILLA CASTRO
Credential	:	R.N.
Telephone Number	:	708-481-6604

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	11/11/2008

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