MEDICARE: LEGACY HEALTH GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	343900000X	Non-emergency Medical Transport (VAN)
3	385H00000X	Respite Care
4	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1841145927
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEGACY HEALTH GROUP LLC

Provider Business Mailing Address
First Line	:	7814 S WINCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5770
Country	:	US
Telephone Number	:	312-206-9801
Fax Number	:

Provider Business Practice Location Address
First Line	:	7814 S WINCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60620-5770
Country	:	US
Telephone Number	:	312-206-9801
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MONIQUE RHIVERS
Credential	:
Telephone Number	:	312-206-9801

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “LEGACY HEALTH GROUP LLC ” Practice Location

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