MEDICARE: AMAZING HOME HEALTH SERVICES, 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	2129758	IL

General Provider Information

NPI Number	:	1558621623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAZING HOME HEALTH SERVICES, INC

Provider Business Mailing Address
First Line	:	6833 S WABASH AVE
Second Line	:	70 W. MADISON ST. SUITE 1406
City	:	CHICAGO
State	:	IL
Zip	:	60637-3911
Country	:	US
Telephone Number	:	773-488-3411
Fax Number	:	773-488-3414

Provider Business Practice Location Address
First Line	:	6833 S WABASH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-3911
Country	:	US
Telephone Number	:	773-488-3411
Fax Number	:	773-488-3414

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CLARISSA MITCHELL
Credential	:
Telephone Number	:	773-818-2657

Provider Enumeration Date	:	05/23/2012
Last Update Date	:	05/23/2012

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