Healthcare Provider Details

I. General information

NPI: 1831906809
Provider Name (Legal Business Name): ESSENTIAL HEALTH SERVICES 1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 FORSYTHIA CT
BOLINGBROOK IL
60490-2032
US

IV. Provider business mailing address

8 FORSYTHIA CT
BOLINGBROOK IL
60490-2032
US

V. Phone/Fax

Practice location:
  • Phone: 773-621-7034
  • Fax:
Mailing address:
  • Phone: 773-621-7034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SHOLA A OWOYEMI
Title or Position: ADMINISTRATOR
Credential: DNP
Phone: 773-621-7034