Healthcare Provider Details

I. General information

NPI: 1083335723
Provider Name (Legal Business Name): MAJESTIC HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1826 SIMPSON ST
EVANSTON IL
60201-3042
US

IV. Provider business mailing address

3525 W PETERSON AVE STE 430
CHICAGO IL
60659-3317
US

V. Phone/Fax

Practice location:
  • Phone: 773-807-2175
  • Fax:
Mailing address:
  • Phone: 920-355-2939
  • Fax: 773-302-1076

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 Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ADEYINKA A JACKSON
Title or Position: DIRECTOR
Credential: LPN
Phone: 773-807-2175