MEDICARE: NORTHWEST HOME CARE, 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	253Z00000X	In Home Supportive Care Agency	3000454	IL

General Provider Information

NPI Number	:	1790151454
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHWEST HOME CARE, INC.

Provider Business Mailing Address
First Line	:	3201 N WILKE RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1437
Country	:	US
Telephone Number	:	847-670-8268
Fax Number	:	847-890-6505

Provider Business Practice Location Address
First Line	:	3201 N WILKE RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-1437
Country	:	US
Telephone Number	:	847-670-8268
Fax Number	:	847-890-6505

Authorized Official
Title or Position	:	CFO
Name	:	IGOR KULBACHNY
Credential	:
Telephone Number	:	847-670-8268

Provider Enumeration Date	:	08/18/2015
Last Update Date	:	04/08/2025

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