MEDICARE: SERAPHIC HOME HEALTH 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	376J00000X	Homemaker
2	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1295607190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERAPHIC HOME HEALTH LLC

Provider Business Mailing Address
First Line	:	4554 N BROADWAY ST STE 218
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5671
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4554 N BROADWAY ST STE 218
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5671
Country	:	US
Telephone Number	:	773-554-4700
Fax Number	:

Authorized Official
Title or Position	:	AGENCY MANAGER
Name	:	BONNAVENTURE OGU
Credential	:
Telephone Number	:	773-554-2490

Provider Enumeration Date	:	09/19/2025
Last Update Date	:	10/14/2025

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Directions to “SERAPHIC HOME HEALTH LLC ” Practice Location

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