MEDICARE: CORLAN HOME SERVICES INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	374U00000X	Home Health Aide
2	376K00000X	Nurse's Aide
3	376J00000X	Homemaker

General Provider Information

NPI Number	:	1669203519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORLAN HOME SERVICES INC.

Provider Business Mailing Address
First Line	:	7117 N RIDGE BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7117 N RIDGE BLVD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3503
Country	:	US
Telephone Number	:	773-979-1979
Fax Number	:

Authorized Official
Title or Position	:	MR
Name	:	KAZEEM ADEDAMOLA
Credential	:
Telephone Number	:	312-823-2082

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	08/12/2024

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