MEDICARE: ICARE HOME HEALTH CORPORATION

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	251E00000X	Home Health Agency	1011369	IL

General Provider Information

NPI Number	:	1992912182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ICARE HOME HEALTH CORPORATION

Provider Business Mailing Address
First Line	:	5962 N LINCOLN AVE
Second Line	:	SUITE 3
City	:	CHICAGO
State	:	IL
Zip	:	60659-3711
Country	:	US
Telephone Number	:	773-334-2515
Fax Number	:	773-334-2516

Provider Business Practice Location Address
First Line	:	5962 N LINCOLN AVE
Second Line	:	SUITE 3
City	:	CHICAGO
State	:	IL
Zip	:	60659-3711
Country	:	US
Telephone Number	:	773-334-2515
Fax Number	:	773-334-2516

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. IRENE G AGUILA
Credential	:	BSN-RN
Telephone Number	:	773-334-2515

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	09/06/2011

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Directions to “ICARE HOME HEALTH CORPORATION ” Practice Location

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