MEDICARE: AKEEB 5 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1104257229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKEEB 5 LLC

Provider Business Mailing Address
First Line	:	9933 S WESTERN AVE STE 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1810
Country	:	US
Telephone Number	:	708-307-9876
Fax Number	:

Provider Business Practice Location Address
First Line	:	9933 S WESTERN AVE STE 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-1810
Country	:	US
Telephone Number	:	708-307-9876
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MISS AMEEDAT A AKEEB
Credential	:
Telephone Number	:	708-307-9876

Provider Enumeration Date	:	11/29/2013
Last Update Date	:	11/29/2013

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