Healthcare Provider Details

I. General information

NPI: 1558278770
Provider Name (Legal Business Name): CHICAGOLAND HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 S HARLEM AVE STE G
BRIDGEVIEW IL
60455-1775
US

IV. Provider business mailing address

8550 S HARLEM AVE STE G
BRIDGEVIEW IL
60455-1775
US

V. Phone/Fax

Practice location:
  • Phone: 709-237-9000
  • Fax: 709-237-1577
Mailing address:
  • Phone: 709-237-9000
  • Fax: 709-237-1577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MR. ISA RIADI
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 219-985-4433