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14D2030505 CLIA NUMBER - EXCELCARE HOME HEALTH (D/B/A) GRACE HEALTH SYSTEMS

Laboratory Demographics

CLIA Number: 14D2030505

Facility Name: EXCELCARE HOME HEALTH (D/B/A) GRACE HEALTH SYSTEMS

Facility Address:
9933 LAWLER - STE 521
SKOKIE, IL
ZIP 60077
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Facility Phone Number: 847 983-0666

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1053693739

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 14D2030505
LAB Type Home Health Agency
Facility Name EXCELCARE HOME HEALTH (D/B/A) GRACE HEALTH SYSTEMS
Street 9933 LAWLER - STE 521
City SKOKIE
State IL
ZIP 60077
Phone 847 983-0666
CertificateType 4
CertificateEffectiveDate 4/25/2024
CertificateExpirationDate 4/24/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024