Organization
PROVIDENCE HOMECARE SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILSON ATIABET (OWNER)
(773) 274-3627
Entity
Organization
Contact information
Practice address
6965 N WESTERN AVE, CHICAGO, IL 60645-4710
(773) 274-3627
Mailing address
6965 N WESTERN AVE, CHICAGO, IL 60645-4710
(773) 274-3627
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
05/19/2025
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