MEDICARE: FAMILY CHOICE 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	1010887	IL

General Provider Information

NPI Number	:	1558529321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHOICE HOME HEALTH, INC.

Provider Business Mailing Address
First Line	:	5933 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5419
Country	:	US
Telephone Number	:	773-774-6630
Fax Number	:

Provider Business Practice Location Address
First Line	:	5933 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5419
Country	:	US
Telephone Number	:	773-774-6630
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY L DENNIS
Credential	:
Telephone Number	:	773-774-6630

Provider Enumeration Date	:	05/29/2008
Last Update Date	:	05/29/2008

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