MEDICARE: HOME INSTEAD SENIOR CARE

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	2313595	IL

General Provider Information

NPI Number	:	1437506730
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME INSTEAD SENIOR CARE

Provider Business Mailing Address
First Line	:	4736 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5120
Country	:	US
Telephone Number	:	773-784-4024
Fax Number	:	773-334-9867

Provider Business Practice Location Address
First Line	:	4736 N MARINE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5120
Country	:	US
Telephone Number	:	773-784-4024
Fax Number	:	773-334-9867

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	HEIDI WIENEKE
Credential	:
Telephone Number	:	773-784-4024

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	05/17/2016

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