# WELLPOINT HOME HEALTH,INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073867784
- **Authorized official:** MRS. TRACY MCKENZIE RN,BSN (PRESIDENT/CEO)
- **Authorized official phone:** (773) 732-8790

## Contact information

- **Practice address:** 10912 S WESTERN AVE, SUITE 4 N, CHICAGO, IL 60643-3205
- **Practice address phone:** (773) 253-9190
- **Practice address fax:** (773) 253-9961
- **Mailing address:** 10912 S WESTERN AVE, SUITE 4 N, CHICAGO, IL 60643-3205
- **Mailing address phone:** (773) 253-9190
- **Mailing address fax:** (773) 253-9961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1011534 | IL | Yes |

## Other

- **Enumeration date:** 11/01/2012
- **Last updated:** 11/01/2012