# EVERGREEN HOME CARE LTD

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

## Provider details

- **NPI number:** 1750496667
- **Authorized official:** GLORIA S KIM RN (PRESIDENT)
- **Authorized official phone:** (847) 470-9280

## Contact information

- **Practice address:** 6041 DEMPSTER ST, MORTON GROVE, IL 60053
- **Practice address phone:** (847) 470-9280
- **Practice address fax:** (847) 470-9282
- **Mailing address:** 6041 DEMPSTER ST, MORTON GROVE, IL 60053-2943
- **Mailing address phone:** (847) 470-9280
- **Mailing address fax:** (847) 470-9928

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 1010796 | IL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | IL | — |

## Other

- **Enumeration date:** 08/20/2006
- **Last updated:** 09/30/2020