Healthcare Provider Details
I. General information
NPI: 1932782364
Provider Name (Legal Business Name): NIKLIFE HOME CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
636 S RIVER RD STE 305
DES PLAINES IL
60016-4624
US
IV. Provider business mailing address
636 S RIVER RD STE 305
DES PLAINES IL
60016-4624
US
V. Phone/Fax
- Phone: 312-224-1001
- Fax: 312-224-1002
- Phone: 312-224-1001
- Fax: 312-224-1002
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251J00000X |
| Taxonomy | Nursing Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
PATRICIA
MARINHO
Title or Position: MANAGER
Credential:
Phone: 312-224-1001