MEDICARE: PACIFIC HOME HEALTH 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		IL

General Provider Information

NPI Number	:	1306830716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PACIFIC HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	4136 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-2440
Country	:	US
Telephone Number	:	773-463-1047
Fax Number	:	773-463-1485

Provider Business Practice Location Address
First Line	:	4136 N KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-2440
Country	:	US
Telephone Number	:	773-463-1047
Fax Number	:	773-463-1485

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LETICIA JACILDO JIMENEZ
Credential	:	RN
Telephone Number	:	773-463-1047

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

1285657833 — DR. DAVID S. EVASKUS D.D.S., M.S.
Practice Location Address:

2440 W PETERSON AVE
CHICAGO, IL
60659-4113

Practice Phone: 773-761-7171
Practice Fax: 773-761-6714

1164438636 — WALGREEN CO
Practice Location Address:

2440 W NORTH AVE
CHICAGO, IL
60647-5331

Practice Phone: 773-489-5607
Practice Fax: 773-489-5785

1194833624 — DR. LOUIS E HALKIAS DDS, MS
Practice Location Address:

2440 W PETERSON AVE
CHICAGO, IL
60659-4113

Practice Phone: 773-761-7171
Practice Fax: 773-761-6714

1316044837 — EVASKUS AND HERZOG, LTD
Practice Location Address:

2440 W PETERSON AVE
CHICAGO, IL
60659-4113

Practice Phone: 773-761-7171
Practice Fax: 773-761-6714

1306063631 — STEVEN HERZOG D.D.S., M.S.
Practice Location Address:

2440 W PETERSON AVE
CHICAGO, IL
60659-4113

Practice Phone: 773-761-7171
Practice Fax: 773-761-6714

1750594073 — REHAB SERVICES (HUBBARD ST), S.C.
Practice Location Address:

2440 W HUBBARD ST
CHICAGO, IL
60612-1435

Practice Phone: 773-463-1313
Practice Fax: 773-463-5311

Directions to “PACIFIC HOME HEALTH CARE, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.