Healthcare Provider Details

I. General information

NPI: 1992648794
Provider Name (Legal Business Name): INDEPENDENT PROFESSIONALS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 N ASHBURY AVE
BOLINGBROOK IL
60440-2451
US

IV. Provider business mailing address

219 N ASHBURY AVE
BOLINGBROOK IL
60440-2451
US

V. Phone/Fax

Practice location:
  • Phone: 331-220-2175
  • Fax:
Mailing address:
  • Phone: 815-782-0658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: TEAQUICIA LESLIE WARD
Title or Position: PRESIDENT OF OPERATIONS
Credential: CNA
Phone: 815-782-0658