MEDICARE: SPITICARE HOME SERVICES LLC

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	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1629868831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPITICARE HOME SERVICES LLC

Provider Business Mailing Address
First Line	:	9332 LANDINGS LN UNIT 601
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-5247
Country	:	US
Telephone Number	:	347-702-2888
Fax Number	:

Provider Business Practice Location Address
First Line	:	9332 LANDINGS LN UNIT 601
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-5247
Country	:	US
Telephone Number	:	347-702-2888
Fax Number	:

Authorized Official
Title or Position	:	OCCUPATIONAL THERAPIST
Name	:	ADINA GONG
Credential	:
Telephone Number	:	347-702-2888

Provider Enumeration Date	:	05/09/2025
Last Update Date	:	01/20/2026

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