MEDICARE: MARYANNS COMFORT HOME CARE 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	253Z00000X	In Home Supportive Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1255291852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARYANNS COMFORT HOME CARE LLC

Provider Business Mailing Address
First Line	:	3628 W LEXINGTON ST FL 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-3670
Country	:	US
Telephone Number	:	312-620-0743
Fax Number	:

Provider Business Practice Location Address
First Line	:	3628 W LEXINGTON ST FL 3
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60624-3670
Country	:	US
Telephone Number	:	312-620-0743
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	AMBER REDDING
Credential	:
Telephone Number	:	478-955-9631

Provider Enumeration Date	:	11/15/2025
Last Update Date	:	02/11/2026

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