Provider Demographics
NPI:1558467688
Name:MED CARE HEALTH MANAGEMENT CORPORATION
Entity Type:Organization
Organization Name:MED CARE HEALTH MANAGEMENT CORPORATION
Other - Org Name:MEDCARE HMC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ABITURAB
Authorized Official - Middle Name:
Authorized Official - Last Name:BOXWALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-825-4060
Mailing Address - Street 1:7820 GRAPHIC DR STE 201
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6278
Mailing Address - Country:US
Mailing Address - Phone:773-685-9025
Mailing Address - Fax:773-685-9066
Practice Address - Street 1:555 E BUTTERFIELD RD STE 205
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-5612
Practice Address - Country:US
Practice Address - Phone:708-344-3100
Practice Address - Fax:708-344-3131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010412163WH0200X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147899OtherMEDICARE
IL1012126OtherIL DEPT OF PUBLIC HEALTH
IL147899Medicare Oscar/Certification