MEDICARE: SWEDISH COVENANT HOSPITAL HOME HEALTH CARE

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	1003474	IL

General Provider Information

NPI Number	:	1659380210
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEDISH COVENANT HOSPITAL HOME HEALTH CARE

Provider Business Mailing Address
First Line	:	2965 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3808
Country	:	US
Telephone Number	:	773-275-9700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2965 W PETERSON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60659-3808
Country	:	US
Telephone Number	:	773-275-9700
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. GARY KRUGEL
Credential	:
Telephone Number	:	773-878-8200

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	11/18/2011

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