MEDICARE: CHRIST MISSIONARY HOME HEALTH AGENCY,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	251S00000X	Community/Behavioral Health Agency		IL

General Provider Information

NPI Number	:	1881143980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRIST MISSIONARY HOME HEALTH AGENCY,INC.

Provider Business Mailing Address
First Line	:	6120 S KEDZIE AVE
Second Line	:	5731 S. WASHTENAW
City	:	CHICAGO
State	:	IL
Zip	:	60629-3319
Country	:	US
Telephone Number	:	312-566-1888
Fax Number	:

Provider Business Practice Location Address
First Line	:	3121 W 71ST ST
Second Line	:	5731 S. WASHTENAW
City	:	CHICAGO
State	:	IL
Zip	:	60629-3003
Country	:	US
Telephone Number	:	312-566-1888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MISS MELLONY L GANT
Credential	:
Telephone Number	:	312-566-1888

Provider Enumeration Date	:	09/29/2016
Last Update Date	:	07/21/2022

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