MEDICARE: PIONEER HEALTHCARE MANAGEMENT, 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	1010291	IL

General Provider Information

NPI Number	:	1679518898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIONEER HEALTHCARE MANAGEMENT, INC.

Provider Business Mailing Address
First Line	:	2720 S RIVER RD
Second Line	:	SUITE 233
City	:	DES PLAINES
State	:	IL
Zip	:	60018-4106
Country	:	US
Telephone Number	:	773-628-7493
Fax Number	:	773-628-7503

Provider Business Practice Location Address
First Line	:	6232 N PULASKI RD
Second Line	:	SUITE 404
City	:	CHICAGO
State	:	IL
Zip	:	60646-5132
Country	:	US
Telephone Number	:	773-628-7493
Fax Number	:	773-628-7503

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. LORELIE PARADERO
Credential	:	RN, BSN
Telephone Number	:	773-628-7493

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	12/09/2014

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