MEDICARE: GENTLE HOME 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	1006188	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1006188	OTHER	IL	HOME HEALTH LICENSE

General Provider Information

NPI Number	:	1568467819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENTLE HOME SERVICES, INC.

Provider Business Mailing Address
First Line	:	570 LAKE COOK RD.
Second Line	:	STE 116
City	:	DEERFIELD
State	:	IL
Zip	:	60015
Country	:	US
Telephone Number	:	847-444-1222
Fax Number	:	847-444-1333

Provider Business Practice Location Address
First Line	:	570 LAKE COOK RD
Second Line	:	STE 204
City	:	DEERFIELD
State	:	IL
Zip	:	60015-4955
Country	:	US
Telephone Number	:	847-444-1222
Fax Number	:	847-444-1333

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MICHAEL D BERLIANT
Credential	:
Telephone Number	:	847-444-1222

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	06/30/2021

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