MEDICARE: MEDCARE

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		IL

General Provider Information

NPI Number	:	1801917331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCARE

Provider Business Mailing Address
First Line	:	6221 N NIAGARA AVE APT 208
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-2117
Country	:	US
Telephone Number	:	773-467-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	3633 W LAKE AVE STE 102
Second Line	:
City	:	GLENVIEW
State	:	IL
Zip	:	60026-5801
Country	:	US
Telephone Number	:	847-724-7697
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST ASSISTANT
Name	:	MRS. DOROTA TRYBA
Credential	:
Telephone Number	:	18477247697

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/22/2020

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