MEDICARE: MA DEAR HOME SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1144279589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MA DEAR HOME SERVICES, INC.

Provider Business Mailing Address
First Line	:	4659 S COTTAGE GROVE AVE
Second Line	:	SUITE #202
City	:	CHICAGO
State	:	IL
Zip	:	60653-4757
Country	:	US
Telephone Number	:	773-373-4663
Fax Number	:	773-268-2472

Provider Business Practice Location Address
First Line	:	1525 E 53RD ST
Second Line	:	SUITE #1006
City	:	CHICAGO
State	:	IL
Zip	:	60615-4557
Country	:	US
Telephone Number	:	773-667-4663
Fax Number	:	773-667-9186

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. RENEE' MORRISSETTE-THOMAS
Credential	:	BHA
Telephone Number	:	773-373-4663

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	03/01/2017

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Directions to “MA DEAR HOME SERVICES, INC. ” Practice Location

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