MEDICARE: COOL CROWN HEALTH CARE SERVICES LIMITED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WH0200X	Home Health Registered Nurse
2	253Z00000X	In Home Supportive Care Agency
3	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1285397935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COOL CROWN HEALTH CARE SERVICES LIMITED

Provider Business Mailing Address
First Line	:	3525 W PETERSON AVE STE 222
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3314
Country	:	US
Telephone Number	:	773-293-7752
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 W PETERSON AVE STE 222
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3314
Country	:	US
Telephone Number	:	773-293-7752
Fax Number	:

Authorized Official
Title or Position	:	AGENCY MANAGER
Name	:	FLORENCE ADEBIYI
Credential	:
Telephone Number	:	773-293-7752

Provider Enumeration Date	:	10/20/2021
Last Update Date	:	05/24/2022

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Directions to “COOL CROWN HEALTH CARE SERVICES LIMITED ” Practice Location

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