Illinois Code § 210 ILCS 55/5

(a) Each application for a provisional license for a home health agency, home services agency, home nursing agency, home
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services placement agency, or home nursing placement agency as provided in Section 4 shall contain
the following information: (1) name, address and location of
the agency; (2) organization and governing structure of agency;
(3) number and qualification of staff; (4) sources of financing
of services and agency; (5) service area; (6) patient load; (7)
agency utilization; (8) service charges; (9) affiliation
agreements with other health care providers;
and (10) such other information as the Department may require. 

 
(b) Applications for licenses shall be in accordance with departmental regulations.

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