Organization
FICC HOME HEALTH CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYAN POTTOW (PRESIDENT)
(773) 283-2835
Entity
Organization
Contact information
Practice address
5648 W. LAWRENCE AVE., CHICAGO, IL 60630-3220
(773) 283-2835
(773) 283-2955
Mailing address
5648 W. LAWRENCE AVE., CHICAGO, IL 60630-3220
(773) 283-2835
(773) 283-2955
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
1011364
IL
Other
Enumeration date
11/01/2011
Last updated
05/11/2012
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