MEDICARE: MRS. SANDRA KAY KUCHMA CNA

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	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1245162098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SANDRA KAY KUCHMA CNA

Provider Business Mailing Address
First Line	:	5045 N KEELER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60630-2715
Country	:	US
Telephone Number	:	630-853-3741
Fax Number	:

Provider Business Practice Location Address
First Line	:	4615 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-2030
Country	:	US
Telephone Number	:	630-853-3741
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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