Healthcare Provider Details

I. General information

NPI: 1417480666
Provider Name (Legal Business Name): KAFF HOMECARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 N LINCOLN AVE
CHICAGO IL
60659-3728
US

IV. Provider business mailing address

5915 N LINCOLN AVE
CHICAGO IL
60659-3728
US

V. Phone/Fax

Practice location:
  • Phone: 773-942-7752
  • Fax: 773-409-5235
Mailing address:
  • Phone: 773-942-7752
  • Fax: 773-409-5235

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: KOFOWOROLA OLOWU
Title or Position: AGENCY MANAGER
Credential:
Phone: 773-968-3315