Healthcare Provider Details

I. General information

NPI: 1225969744
Provider Name (Legal Business Name): HOME FIRST HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2026
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11615 S HARVARD AVE
CHICAGO IL
60628-5427
US

IV. Provider business mailing address

11615 S HARVARD AVE
CHICAGO IL
60628-5427
US

V. Phone/Fax

Practice location:
  • Phone: 872-370-8974
  • Fax:
Mailing address:
  • Phone: 872-370-8974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: RAESHAWN PETTIS
Title or Position: OWNER
Credential: CNA
Phone: 872-370-8974