MEDICARE: EXTENDED FAMILY IN-HOME SENIOR CARE INC

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1801730627
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXTENDED FAMILY IN-HOME SENIOR CARE INC

Provider Business Mailing Address
First Line	:	5901 N CICERO AVE STE 308
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5719
Country	:	US
Telephone Number	:	773-617-7312
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 N CICERO AVE STE 308
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-5719
Country	:	US
Telephone Number	:	773-617-7312
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LAUREN WEATHERSPOON
Credential	:
Telephone Number	:	773-617-7312

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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