Healthcare Provider Details

I. General information

NPI: 1447631585
Provider Name (Legal Business Name): ESK HOME SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2015
Last Update Date: 04/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 PLAINFIELD RD STE 3
JOLIET IL
60435-4095
US

IV. Provider business mailing address

1523 PLAINFIELD RD STE 3
JOLIET IL
60435-4095
US

V. Phone/Fax

Practice location:
  • Phone: 815-836-2635
  • Fax: 708-668-4187
Mailing address:
  • Phone: 815-836-2635
  • Fax: 708-668-4187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3000505
License Number StateIL

VIII. Authorized Official

Name: MR. MICHAEL G. SHACKEL
Title or Position: SECRETARY
Credential:
Phone: 815-836-2635