MEDICARE: NORTHWEST HOME 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	1011043	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1011043	OTHER	IL	HOME HEALTH LICENSE

General Provider Information

NPI Number	:	1447667555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST HOME CARE, INC.

Provider Business Mailing Address
First Line	:	868 N MILWAUKEE AVE
Second Line	:	CHICAGO
City	:	CHICAGO
State	:	IL
Zip	:	60642-4103
Country	:	US
Telephone Number	:	312-724-6655
Fax Number	:	312-674-7504

Provider Business Practice Location Address
First Line	:	868 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60642-4103
Country	:	US
Telephone Number	:	312-724-6655
Fax Number	:	312-674-7504

Authorized Official
Title or Position	:	CFO
Name	:	IGOR KULBACHNY
Credential	:
Telephone Number	:	847-670-8268

Provider Enumeration Date	:	07/21/2014
Last Update Date	:	04/08/2025

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Directions to “NORTHWEST HOME CARE, INC. ” Practice Location

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