Provider Demographics
NPI:1760474076
Name:CARE CHOICE HOME HEALTH, INC.
Entity Type:Organization
Organization Name:CARE CHOICE HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:FROILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-329-0648
Mailing Address - Street 1:7840 LINCOLN AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3658
Mailing Address - Country:US
Mailing Address - Phone:847-329-0648
Mailing Address - Fax:
Practice Address - Street 1:7840 LINCOLN AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3658
Practice Address - Country:US
Practice Address - Phone:847-329-0648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010265251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL147760Medicare ID - Type Unspecified