MEDICARE: FIRST AVAILABLE MEDICAL STAFFING 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	:	1861898835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST AVAILABLE MEDICAL STAFFING INC

Provider Business Mailing Address
First Line	:	4552 1/2 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5689
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4552 1/2 N BROADWAY ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5689
Country	:	US
Telephone Number	:	773-784-2855
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	IGBINOGHODUA J EDOMWONYI
Credential	:
Telephone Number	:	773-784-2855

Provider Enumeration Date	:	11/18/2014
Last Update Date	:	11/18/2014

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