Provider Demographics
NPI:1669639746
Name:MEDICOSE HOME HEALTHCARE SVS INC
Entity Type:Organization
Organization Name:MEDICOSE HOME HEALTHCARE SVS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSEFZAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-322-5960
Mailing Address - Street 1:9605 KEELER AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1127
Mailing Address - Country:US
Mailing Address - Phone:847-674-3240
Mailing Address - Fax:847-674-3318
Practice Address - Street 1:9605 KEELER AVE
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1127
Practice Address - Country:US
Practice Address - Phone:847-674-3240
Practice Address - Fax:847-674-3318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1898321251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health