MEDICARE: IN HIS HANDS 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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1548435068
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HIS HANDS HOME HEALTH,INC

Provider Business Mailing Address
First Line	:	1431 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1920
Country	:	US
Telephone Number	:	773-868-1500
Fax Number	:	773-472-4300

Provider Business Practice Location Address
First Line	:	1431 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60613-1920
Country	:	US
Telephone Number	:	773-868-1500
Fax Number	:	773-472-4300

Authorized Official
Title or Position	:	HEAD BILLING
Name	:	GLADYSWINNA GONZALES PINOL
Credential	:
Telephone Number	:	773-349-7792

Provider Enumeration Date	:	04/25/2008
Last Update Date	:	04/25/2008

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