Healthcare Provider Details

I. General information

NPI: 1477231231
Provider Name (Legal Business Name): HUMILITY HEALTH CARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9932 S WESTERN AVE
CHICAGO IL
60643-1831
US

IV. Provider business mailing address

500 PARK AVE APT 627
CALUMET CITY IL
60409-5034
US

V. Phone/Fax

Practice location:
  • Phone: 773-656-7427
  • Fax:
Mailing address:
  • Phone: 773-656-7427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MARKETTA MCCOLLOUGH
Title or Position: MANAGING MEMBER
Credential:
Phone: 773-656-7427