MEDICARE: ADDUS HEALTHCARE, 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	251C00000X	Developmentally Disabled Services Day Training Agency
2	251F00000X	Home Infusion Agency
3	251F00000X	Home Infusion Agency	25000769	CA
4	251J00000X	Nursing Care Agency
5	251J00000X	Nursing Care Agency	25000769	CA
6	251E00000X	Home Health Agency	250000769	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750347365
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDUS HEALTHCARE, INC.

Provider Business Mailing Address
First Line	:	2401 S PLUM GROVE RD
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067
Country	:	US
Telephone Number	:	847-303-5300
Fax Number	:	847-303-5376

Provider Business Practice Location Address
First Line	:	2375 CHICAGO AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-6902
Country	:	US
Telephone Number	:	951-774-3023
Fax Number	:	951-774-3027

Authorized Official
Title or Position	:	NATIONAL CONTRACTS
Name	:	MS. DIANE KUMARICH
Credential	:	RN, MS, MBA
Telephone Number	:	847-303-5300

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	01/16/2013

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Directions to “ADDUS HEALTHCARE, INC. ” Practice Location

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