Healthcare Provider Details

I. General information

NPI: 1932723988
Provider Name (Legal Business Name): MERCY REIGNS HOMECARE SERVICES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3116 PRAIRIE ST
AURORA IL
60506-9229
US

IV. Provider business mailing address

3116 PRAIRIE ST
AURORA IL
60506-9229
US

V. Phone/Fax

Practice location:
  • Phone: 630-566-9165
  • Fax:
Mailing address:
  • Phone: 630-566-9165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MR. IVO EWANG EWANE
Title or Position: OWNER
Credential: MBA, RN.
Phone: 630-430-6174