MEDICARE: 1 CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103T00000X	Psychologist
3	104100000X	Social Worker
4	207Q00000X	Family Medicine Physician
5	207QA0401X	Addiction Medicine (Family Medicine) Physician
6	207V00000X	Obstetrics & Gynecology Physician
7	208000000X	Pediatrics Physician
8	208100000X	Physical Medicine & Rehabilitation Physician
9	2083X0100X	Occupational Medicine Physician
10	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
11	208600000X	Surgery Physician
12	2086S0129X	Vascular Surgery Physician
13	208C00000X	Colon & Rectal Surgery Physician
14	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
15	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1942649421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1 CARE INC.

Provider Business Mailing Address
First Line	:	4800 S CHICAGO BEACH DR
Second Line	:	SUITE 901N
City	:	CHICAGO
State	:	IL
Zip	:	60615-7032
Country	:	US
Telephone Number	:	773-251-4625
Fax Number	:	773-289-0888

Provider Business Practice Location Address
First Line	:	4800 S CHICAGO BEACH DR
Second Line	:	SUITE 901N
City	:	CHICAGO
State	:	IL
Zip	:	60615-7032
Country	:	US
Telephone Number	:	773-251-4625
Fax Number	:	773-289-0888

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MERLIN KELSICK
Credential	:
Telephone Number	:	773-251-4625

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	06/18/2013

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