MEDICARE: SINCERECARE HOME SERVICES LLC

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	253Z00000X	In Home Supportive Care Agency	3001542	IL

General Provider Information

NPI Number	:	1912493289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SINCERECARE HOME SERVICES LLC

Provider Business Mailing Address
First Line	:	561 GORDON AVE
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-3528
Country	:	US
Telephone Number	:	312-285-4660
Fax Number	:

Provider Business Practice Location Address
First Line	:	561 GORDON AVE
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-3528
Country	:	US
Telephone Number	:	312-285-4660
Fax Number	:

Authorized Official
Title or Position	:	AGENCY MANAGER
Name	:	ANTANIQUE HAMPTON
Credential	:
Telephone Number	:	312-285-4660

Provider Enumeration Date	:	07/10/2018
Last Update Date	:	07/10/2018

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