Provider Demographics
NPI:1407933914
Name:WELLCARE HOME HEALTH INC
Entity Type:Organization
Organization Name:WELLCARE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-562-4041
Mailing Address - Street 1:3605 WOODHEAD DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60053
Mailing Address - Country:US
Mailing Address - Phone:847-562-4041
Mailing Address - Fax:847-562-4042
Practice Address - Street 1:3605 WOODHEAD DR
Practice Address - Street 2:SUITE 107
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60053
Practice Address - Country:US
Practice Address - Phone:847-562-4041
Practice Address - Fax:847-562-4042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010446251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
147835Medicare ID - Type Unspecified