Healthcare Provider Details

I. General information

NPI: 1477481620
Provider Name (Legal Business Name): KM ELITE COMFORT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 16TH ST
NORTH CHICAGO IL
60064-2016
US

IV. Provider business mailing address

1412 16TH ST
NORTH CHICAGO IL
60064-2016
US

V. Phone/Fax

Practice location:
  • Phone: 224-302-3610
  • Fax: 224-302-4291
Mailing address:
  • Phone: 224-302-3610
  • Fax: 224-302-4291

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: MS. KEIAIRA A MONTGOMERY
Title or Position: MANAGING MEMBER
Credential: DSP,CNA,LPN STUDENT
Phone: 708-508-4210