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NPI Code Detail

MEDICARE: HUMILITY HEALTH CARE SERVICES LLC

MEDICARE: HUMILITY HEALTH CARE SERVICES 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
1251E00000XHome Health Agency
2314000000XSkilled Nursing Facility
3313M00000XNursing Facility/Intermediate Care Facility
4253Z00000XIn Home Supportive Care Agency
5376J00000XHomemaker

General Provider Information

NPI Number : 1477231231
Entity Type Code : Organization
Provider Name (Legal Business Name) : HUMILITY HEALTH CARE SERVICES LLC
Provider Business Mailing Address
First Line : 500 PARK AVE APT 627
Second Line :
City : CALUMET CITY
State : IL
Zip : 60409-5034
Country : US
Telephone Number : 773-656-7427
Fax Number :
Provider Business Practice Location Address
First Line : 9932 S WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1831
Country : US
Telephone Number : 773-656-7427
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : DR. MARKETTA MCCOLLOUGH
Credential :
Telephone Number : 773-656-7427
Provider Enumeration Date : 07/10/2023
Last Update Date : 03/08/2026

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Directions to “HUMILITY HEALTH CARE SERVICES LLC ” Practice Location

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