Healthcare Provider Details

I. General information

NPI: 1457226219
Provider Name (Legal Business Name): SOJ HOME HEALTHCARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1417 W TOUHY AVE APT D
CHICAGO IL
60626-2692
US

IV. Provider business mailing address

1417 W TOUHY AVE APT D
CHICAGO IL
60626-2692
US

V. Phone/Fax

Practice location:
  • Phone: 773-668-3710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: MRS. EDNA KING
Title or Position: PRESIDENT
Credential:
Phone: 773-668-3710