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NPI Code Detail

MEDICARE: PROCARE HOME HEALTH INC

MEDICARE: PROCARE HOME HEALTH 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
1251E00000XHome Health Agency1009042IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15142OTHERILBLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number : 1497739544
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROCARE HOME HEALTH INC
Provider Business Mailing Address
First Line : 200 HOWARD AVE
Second Line : STE 248
City : DES PLAINES
State : IL
Zip : 60018-5906
Country : US
Telephone Number : 847-803-0774
Fax Number : 847-803-0821
Provider Business Practice Location Address
First Line : 200 HOWARD AVE
Second Line : STE 248
City : DES PLAINES
State : IL
Zip : 60018-5906
Country : US
Telephone Number : 847-803-0774
Fax Number : 847-803-0821
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : ANNETTE M HENEGHAN
Credential : RN
Telephone Number : 847-803-0774
Provider Enumeration Date : 12/02/2005
Last Update Date : 11/16/2011

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Directions to “PROCARE HOME HEALTH INC ” Practice Location

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