Healthcare Provider Details

I. General information

NPI: 1841145927
Provider Name (Legal Business Name): LEGACY HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2026
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7814 S WINCHESTER AVE
CHICAGO IL
60620-5770
US

IV. Provider business mailing address

7814 S WINCHESTER AVE
CHICAGO IL
60620-5770
US

V. Phone/Fax

Practice location:
  • Phone: 312-206-9801
  • Fax:
Mailing address:
  • Phone: 312-206-9801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE RHIVERS
Title or Position: CEO
Credential:
Phone: 312-206-9801