MEDICARE: HOME HEALTH PHYSICIANS, PC

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	174400000X	Specialist	36112029	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881611440
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME HEALTH PHYSICIANS, PC

Provider Business Mailing Address
First Line	:	4958 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2640
Country	:	US
Telephone Number	:	773-290-8124
Fax Number	:

Provider Business Practice Location Address
First Line	:	4958 W IRVING PARK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-2640
Country	:	US
Telephone Number	:	773-290-8124
Fax Number	:

Authorized Official
Title or Position	:	HUMAN RESOURCES PERSONAL
Name	:	BERTHA A. CANO
Credential	:
Telephone Number	:	773-290-8124

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/21/2022

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