MEDICARE: INNOVATIVE SENIOR CARE HOME HEALTH OF CHICAGO, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist
4	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1326713611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE SENIOR CARE HOME HEALTH OF CHICAGO, LLC

Provider Business Mailing Address
First Line	:	PO BOX 51266
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70505-1266
Country	:	US
Telephone Number	:	337-233-1307
Fax Number	:	337-443-4154

Provider Business Practice Location Address
First Line	:	3121 N SHERIDAN RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-4945
Country	:	US
Telephone Number	:	773-404-5433
Fax Number	:	773-404-1591

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA L. PROFFITT
Credential	:
Telephone Number	:	337-233-1307

Provider Enumeration Date	:	08/10/2021
Last Update Date	:	01/30/2026

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