Healthcare Provider Details

I. General information

NPI: 1831010206
Provider Name (Legal Business Name): MAISON MIRACLE 360 HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W ALGONQUIN RD
PALATINE IL
60067-4771
US

IV. Provider business mailing address

1500 W ALGONQUIN RD
PALATINE IL
60067-4771
US

V. Phone/Fax

Practice location:
  • Phone: 224-422-2099
  • Fax: 224-215-6339
Mailing address:
  • Phone: 224-422-2099
  • Fax: 224-215-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: YILDIZ KUCUK
Title or Position: MANAGER
Credential:
Phone: 224-422-2099