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NPI Code Detail

MEDICARE: ELC HEALTHCARE, LLC

MEDICARE: ELC HEALTHCARE, LLC
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 AgencyIL1010401IL

General Provider Information

NPI Number : 1306868369
Entity Type Code : Organization
Provider Name (Legal Business Name) : ELC HEALTHCARE, LLC
Provider Business Mailing Address
First Line : 1925 N HARLEM AVENUE
Second Line : #108
City : CHICAGO
State : IL
Zip : 60707-1059
Country : US
Telephone Number : 708-383-2191
Fax Number : 708-383-2509
Provider Business Practice Location Address
First Line : 1925 N HARLEM AVE
Second Line : #108
City : CHICAGO
State : IL
Zip : 60707-3743
Country : US
Telephone Number : 708-383-2191
Fax Number : 708-383-2509
Authorized Official
Title or Position : PRESIDENT
Name : MISS MARIA EVELINA CRUZ
Credential : RN
Telephone Number : 708-383-2191
Provider Enumeration Date : 07/25/2006
Last Update Date : 09/23/2016

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Directions to “ELC HEALTHCARE, LLC ” Practice Location

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