MEDICARE: OCTICARE, 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

General Provider Information

NPI Number	:	1790307411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCTICARE, INC.

Provider Business Mailing Address
First Line	:	770 ROCKWELL LN
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-6218
Country	:	US
Telephone Number	:	847-454-7777
Fax Number	:	224-253-4888

Provider Business Practice Location Address
First Line	:	200 E EVERGREEN AVE STE 127
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-3294
Country	:	US
Telephone Number	:	224-414-2088
Fax Number	:	224-253-4888

Authorized Official
Title or Position	:	CEO
Name	:	ANGELA WILSON
Credential	:
Telephone Number	:	847-454-7777

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	10/27/2025

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