MEDICARE: MODEL 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	1007244	IL

General Provider Information

NPI Number	:	1316047202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MODEL HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	5202 WASHINGTON ST
Second Line	:	SUITE #8
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4772
Country	:	US
Telephone Number	:	630-322-8122
Fax Number	:	630-322-8126

Provider Business Practice Location Address
First Line	:	5202 WASHINGTON ST
Second Line	:	SUITE #8
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-4772
Country	:	US
Telephone Number	:	630-322-8122
Fax Number	:	630-322-8126

Authorized Official
Title or Position	:	ADMINISTRATOR DIRECTOR OF NURSING
Name	:	MRS. CRISPINA D UNABIA
Credential	:	RN
Telephone Number	:	630-322-8122

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	08/22/2020

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