MEDICARE: HOME CARE PLUS 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	332B00000X	Durable Medical Equipment & Medical Supplies	203-00692	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1621579	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1962485151
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME CARE PLUS INC

Provider Business Mailing Address
First Line	:	4744 N WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2013
Country	:	US
Telephone Number	:	773-267-5123
Fax Number	:	872-806-2867

Provider Business Practice Location Address
First Line	:	4744 N WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2013
Country	:	US
Telephone Number	:	773-267-5123
Fax Number	:	872-806-2867

Authorized Official
Title or Position	:	CEO
Name	:	MR. LEE P PORTOKALIS
Credential	:
Telephone Number	:	773-267-5123

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	11/19/2018

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Directions to “HOME CARE PLUS INC ” Practice Location

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