Provider Demographics
NPI:1043327919
Name:MEDCARE HOME HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:MEDCARE HOME HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-240-0960
Mailing Address - Street 1:195 N HARBOR DR
Mailing Address - Street 2:SUITE 5505
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-7514
Mailing Address - Country:US
Mailing Address - Phone:312-240-0960
Mailing Address - Fax:312-240-0963
Practice Address - Street 1:195 N HARBOR DR
Practice Address - Street 2:SUITE 5505
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-7514
Practice Address - Country:US
Practice Address - Phone:312-240-0960
Practice Address - Fax:312-240-0963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010362251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147846Medicare ID - Type UnspecifiedMEDICARE NUMBER