MEDICARE: CHICAGO 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
1	251E00000X	Home Health Agency	1010513	IL

General Provider Information

NPI Number	:	1326061458
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO HEALTH INC.

Provider Business Mailing Address
First Line	:	3701 N ELSTON AVE
Second Line	:	2ND FLR
City	:	CHICAGO
State	:	IL
Zip	:	60618-4309
Country	:	US
Telephone Number	:	773-478-7064
Fax Number	:	773-478-7136

Provider Business Practice Location Address
First Line	:	3701 N ELSTON AVE
Second Line	:	2ND FLR
City	:	CHICAGO
State	:	IL
Zip	:	60618-4309
Country	:	US
Telephone Number	:	773-478-7064
Fax Number	:	773-478-7136

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. ESTELITO T MARTINEZ
Credential	:
Telephone Number	:	773-478-7064

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/09/2007

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