MEDICARE: CARE CENTERS HEALTH SYSTEMS LIMITED

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	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	203.00378	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0241503	OTHER	KY	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	01625203	OTHER	IL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801802012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARE CENTERS HEALTH SYSTEMS LIMITED

Provider Business Mailing Address
First Line	:	200 HOWARD AVE
Second Line	:	STE 250
City	:	DES PLAINES
State	:	IL
Zip	:	60018-5909
Country	:	US
Telephone Number	:	224-612-5662
Fax Number	:	224-612-5862

Provider Business Practice Location Address
First Line	:	200 HOWARD AVE
Second Line	:	SUITE 250
City	:	DES PLAINES
State	:	IL
Zip	:	60018-5906
Country	:	US
Telephone Number	:	224-612-5662
Fax Number	:	224-612-5862

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. YISHAI BRONER
Credential	:
Telephone Number	:	224-612-5680

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	09/25/2009

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Directions to “CARE CENTERS HEALTH SYSTEMS LIMITED ” Practice Location

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