MEDICARE: ADDUS HEALTHCARE, 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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1588085633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDUS HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	2300 WARRENVILLE RD
Second Line	:	SUITE 100
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-1765
Country	:	US
Telephone Number	:	630-296-3400
Fax Number	:	630-487-2713

Provider Business Practice Location Address
First Line	:	3870 FOOTHILLS RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4631
Country	:	US
Telephone Number	:	575-523-8885
Fax Number	:

Authorized Official
Title or Position	:	NATIONAL CONTRACTS
Name	:	MS. DIANE KUMARICH
Credential	:	RN, MS, MBA
Telephone Number	:	630-296-3400

Provider Enumeration Date	:	12/16/2013
Last Update Date	:	11/13/2018

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