Healthcare Provider Details

I. General information

NPI: 1295607190
Provider Name (Legal Business Name): SERAPHIC HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4554 N BROADWAY ST STE 218
CHICAGO IL
60640-5671
US

IV. Provider business mailing address

4554 N BROADWAY ST STE 218
CHICAGO IL
60640-5671
US

V. Phone/Fax

Practice location:
  • Phone: 773-554-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: BONNAVENTURE OGU
Title or Position: AGENCY MANAGER
Credential:
Phone: 773-554-2490