MEDICARE: ASPEN HOME HEALTH, MEDICAL & REHABILITATION SERVICE, INCORPORATED

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	1010580	IL

General Provider Information

NPI Number	:	1497701403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN HOME HEALTH, MEDICAL & REHABILITATION SERVICE, INCORPORATED

Provider Business Mailing Address
First Line	:	5244 W IRVING PARK RD
Second Line	:	# 1 WEST
City	:	CHICAGO
State	:	IL
Zip	:	60641-2596
Country	:	US
Telephone Number	:	773-685-7338
Fax Number	:	773-685-3181

Provider Business Practice Location Address
First Line	:	5244 W IRVING PARK RD
Second Line	:	# 1 WEST
City	:	CHICAGO
State	:	IL
Zip	:	60641-2596
Country	:	US
Telephone Number	:	773-685-7338
Fax Number	:	773-685-3181

Authorized Official
Title or Position	:	PRESIDENT/DIRECTOR OF NURSING
Name	:	MR. ADRIAN IOAN PINTEA
Credential	:	RN
Telephone Number	:	773-685-7338

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	04/27/2010

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