MEDICARE: HOSPICE OF THE CALUMET AREA, 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	251G00000X	Community Based Hospice Care Agency	2001006	IL

General Provider Information

NPI Number	:	1407919293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPICE OF THE CALUMET AREA, INC.

Provider Business Mailing Address
First Line	:	3224 RIDGE RD
Second Line	:	SUITE 202 & 203
City	:	LANSING
State	:	IL
Zip	:	60438-3129
Country	:	US
Telephone Number	:	708-895-8332
Fax Number	:	219-922-1947

Provider Business Practice Location Address
First Line	:	3224 RIDGE RD
Second Line	:	SUITE 202 & 203
City	:	LANSING
State	:	IL
Zip	:	60438-3129
Country	:	US
Telephone Number	:	708-895-8332
Fax Number	:	219-922-2732

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ADRIANNE MAY
Credential	:
Telephone Number	:	708-895-8332

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	06/01/2016

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