MEDICARE: HOUSECALL 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
1	163WH0200X	Home Health Registered Nurse
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1386183945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSECALL HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	342 N WATER ST
Second Line	:	SUITE 600
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-5514
Country	:	US
Telephone Number	:	262-558-4338
Fax Number	:

Provider Business Practice Location Address
First Line	:	342 N WATER ST
Second Line	:	SUITE 600
City	:	MILWAUKEE
State	:	WI
Zip	:	53202-5514
Country	:	US
Telephone Number	:	262-558-4338
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DANIEL MCQUARY
Credential	:
Telephone Number	:	414-526-8143

Provider Enumeration Date	:	02/15/2017
Last Update Date	:	02/15/2017

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