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NPI Code Detail

MEDICARE: DYNA CARE HOME HEALTH, INC.

MEDICARE: DYNA CARE HOME HEALTH, 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
1251E00000XHome Health Agency1007277IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19762OTHERILBLUECROSS BLUESHIELD

General Provider Information

NPI Number : 1235293812
Entity Type Code : Organization
Provider Name (Legal Business Name) : DYNA CARE HOME HEALTH, INC.
Provider Business Mailing Address
First Line : 18454 W WEST CREEK DR
Second Line :
City : TINLEY PARK
State : IL
Zip : 60477-6273
Country : US
Telephone Number : 708-560-7200
Fax Number : 708-560-7350
Provider Business Practice Location Address
First Line : 3519 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-1137
Country : US
Telephone Number : 773-665-2060
Fax Number : 773-665-2090
Authorized Official
Title or Position : CHIEF OPERATING OFFICER
Name : MR. ABI TURAB BOXWALLA
Credential :
Telephone Number : 708-560-7200
Provider Enumeration Date : 12/20/2006
Last Update Date : 08/22/2020

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