MEDICARE: ASI

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1497006563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASI

Provider Business Mailing Address
First Line	:	2619 W. ARMITAGE AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4208
Country	:	US
Telephone Number	:	773-278-5130
Fax Number	:	773-278-1380

Provider Business Practice Location Address
First Line	:	2619 W. ARMITAGE AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4208
Country	:	US
Telephone Number	:	773-278-5130
Fax Number	:	773-278-1380

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. REBECCA CRUZ
Credential	:	MSW
Telephone Number	:	773-278-5130

Provider Enumeration Date	:	09/28/2012
Last Update Date	:	11/27/2012

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Directions to “ASI ” Practice Location

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