MEDICARE: ADVANCE HOME HEALTH CARE, LTD.

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	IL1010282	IL
2	251E00000X	Home Health Agency	1011340	IL

General Provider Information

NPI Number	:	1699881888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE HOME HEALTH CARE, LTD.

Provider Business Mailing Address
First Line	:	5948 N. MILWAUKEE AVE.
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646
Country	:	US
Telephone Number	:	773-850-3000
Fax Number	:	773-850-3001

Provider Business Practice Location Address
First Line	:	4701 N CUMBERLAND AVE
Second Line	:	SUITE 13-14
City	:	NORRIDGE
State	:	IL
Zip	:	60706-2905
Country	:	US
Telephone Number	:	708-452-1022
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. SARAH CAPAGAL
Credential	:	RN
Telephone Number	:	773-850-3000

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	05/25/2016

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