Healthcare Provider Details

I. General information

NPI: 1215504881
Provider Name (Legal Business Name): COMPLETE HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 01/29/2023
Certification Date: 01/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W BOUGHTON RD STE A
BOLINGBROOK IL
60440-1998
US

IV. Provider business mailing address

402 W BOUGHTON RD STE A
BOLINGBROOK IL
60440-1998
US

V. Phone/Fax

Practice location:
  • Phone: 630-300-0446
  • Fax: 630-300-0446
Mailing address:
  • Phone: 630-300-0446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ISOKEN FRANCA OGBOMO
Title or Position: PRESIDENT/CEO
Credential: FNP
Phone: 312-451-6418