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Organization

WELLPOINT HOME HEALTH,INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. TRACY MCKENZIE RN,BSN (PRESIDENT/CEO)
(773) 732-8790
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011534
IL

Other

Enumeration date
11/01/2012
Last updated
11/01/2012
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