Healthcare Provider Details

I. General information

NPI: 1558066894
Provider Name (Legal Business Name): HAYATH SENIOR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4606 OLD GRAND AVE STE A6
GURNEE IL
60031-2607
US

IV. Provider business mailing address

4056 KENWOOD AVE
GURNEE IL
60031-2864
US

V. Phone/Fax

Practice location:
  • Phone: 773-941-1744
  • Fax: 224-214-3774
Mailing address:
  • Phone: 773-941-1744
  • Fax: 224-214-3774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SOFIA FATIMA KHAN
Title or Position: PRESIDENT
Credential:
Phone: 773-941-1744