MEDICARE: ACE 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1477274454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE HOME CARE, INC

Provider Business Mailing Address
First Line	:	1717 HOWARD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-3735
Country	:	US
Telephone Number	:	773-332-9568
Fax Number	:	773-345-4637

Provider Business Practice Location Address
First Line	:	1717 HOWARD ST
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-3735
Country	:	US
Telephone Number	:	773-332-9568
Fax Number	:	773-345-4637

Authorized Official
Title or Position	:	MANAGER
Name	:	NELIA LADLAD
Credential	:
Telephone Number	:	773-332-9568

Provider Enumeration Date	:	09/07/2022
Last Update Date	:	09/07/2022

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