MEDICARE: EAST CALUMET HELATH SERVICES 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	3336C0003X	Community/Retail Pharmacy		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1478571	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	1478571	OTHER		OTHER ID NUMBER

General Provider Information

NPI Number	:	1982619599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST CALUMET HELATH SERVICES INC

Provider Business Mailing Address
First Line	:	335 E 51ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-3510
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	335 E 51ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60615-3510
Country	:	US
Telephone Number	:	773-624-4925
Fax Number	:	773-624-0991

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAVINDER SETHI
Credential	:
Telephone Number	:	773-624-4925

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	04/20/2008

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Directions to “EAST CALUMET HELATH SERVICES INC ” Practice Location

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