MEDICARE: MILEAGE AGENCY 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

General Provider Information

NPI Number	:	1396604435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILEAGE AGENCY LLC

Provider Business Mailing Address
First Line	:	500 W SILVER SPRING DR STE K200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-5052
Country	:	US
Telephone Number	:	612-223-1115
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 W SILVER SPRING DR
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53217-5051
Country	:	US
Telephone Number	:	612-223-1115
Fax Number	:

Authorized Official
Title or Position	:	OWNER / MANAGING MEMBER
Name	:	ABDIRAHIM QAYBDID
Credential	:
Telephone Number	:	612-223-1115

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “MILEAGE AGENCY LLC ” Practice Location

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