MEDICARE: 1938 HOMECARE SERVICES

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	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164135562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	1938 HOMECARE SERVICES

Provider Business Mailing Address
First Line	:	4247 W ROOSEVELT RD STE 201
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-3953
Country	:	US
Telephone Number	:	708-303-8349
Fax Number	:

Provider Business Practice Location Address
First Line	:	4247 W ROOSEVELT RD STE 201
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-3953
Country	:	US
Telephone Number	:	708-303-8349
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KATTIE BANKS
Credential	:
Telephone Number	:	708-303-8349

Provider Enumeration Date	:	12/30/2022
Last Update Date	:	11/07/2024

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