Lifecare@Home

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

3000305 Issued in IL

Legal business name

LIFECARE@HOME

Practice address

5550 S Shore Dr
Chicago, IL 60637-5051

Phone

(773) 358-7438

Fax

(773) 752-0056

NPI assigned

Nov 18, 2015

Organization subpart

Yes

Parent organization

MONTGOMERY PLACEAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bobby Pope

Title

Administrator

Phone

(774) 447-3601

Specialties & licenses 2

Addresses

Part of

Montgomery Place

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1447804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1275907990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5550 S SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375051",
            "telephone_number": "773-358-7438",
            "fax_number": "773-752-0056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5550 S SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606375051",
            "telephone_number": "773-358-7438",
            "fax_number": "773-752-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE@HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONTGOMERY PLACE",
        "enumeration_date": "2015-11-18",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "774-447-3601",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "IL",
            "license": "3000305",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": "3000305",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Nursing Care Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.