Healthcare Provider Details

I. General information

NPI: 1215635586
Provider Name (Legal Business Name): MAFOLUX HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2023
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 BARCLAY BLVD STE 372
LINCOLNSHIRE IL
60069-3610
US

IV. Provider business mailing address

111 BARCLAY BLVD STE 372
LINCOLNSHIRE IL
60069-3610
US

V. Phone/Fax

Practice location:
  • Phone: 708-943-7300
  • Fax: 708-943-7300
Mailing address:
  • Phone: 708-943-7300
  • Fax: 708-943-7300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MICHEAL O AFOLABI
Title or Position: ADMINISTRATOR
Credential:
Phone: 872-302-9701