MEDICARE: DYNAMIC HOMECARE 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	1642234	IL
2	251G00000X	Community Based Hospice Care Agency	1655311	IL

General Provider Information

NPI Number	:	1689670382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC HOMECARE INC

Provider Business Mailing Address
First Line	:	546 W LINCOLN AVE
Second Line	:
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2442
Country	:	US
Telephone Number	:	217-345-4614
Fax Number	:	217-348-0057

Provider Business Practice Location Address
First Line	:	546 W LINCOLN AVE
Second Line	:
City	:	CHARLESTON
State	:	IL
Zip	:	61920-2442
Country	:	US
Telephone Number	:	217-345-4614
Fax Number	:	217-348-0057

Authorized Official
Title or Position	:	CEO
Name	:	MRS. DEATRICE ELLEN GREATHOUSE
Credential	:	RN
Telephone Number	:	217-345-4614

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	09/11/2025

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Directions to “DYNAMIC HOMECARE INC ” Practice Location

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