Healthcare Provider Details

I. General information

NPI: 1891557500
Provider Name (Legal Business Name): SIMSULT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2024
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 N LINCOLN AVE STE 222
CHICAGO IL
60659-4668
US

IV. Provider business mailing address

5875 N LINCOLN AVE STE 222
CHICAGO IL
60659-4668
US

V. Phone/Fax

Practice location:
  • Phone: 773-742-7434
  • Fax:
Mailing address:
  • Phone: 773-742-7434
  • 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: MOJISOLA LUGBOSO
Title or Position: PRESIDENT
Credential:
Phone: 773-742-7434