MEDICARE: SAMARITAN SENIOR CARE LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251J00000X	Nursing Care Agency
2	253Z00000X	In Home Supportive Care Agency
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1255023222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMARITAN SENIOR CARE LLC

Provider Business Mailing Address
First Line	:	24131 DOUGLAS DR
Second Line	:
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-8433
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	18W140 BUTTERFIELD RD FL 15
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-4843
Country	:	US
Telephone Number	:	613-613-7788
Fax Number	:	630-613-7787

Authorized Official
Title or Position	:	AGENCY DIRECTOR
Name	:	JOHN BAGENDA
Credential	:
Telephone Number	:	630-877-8207

Provider Enumeration Date	:	05/25/2023
Last Update Date	:	08/12/2024

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