Healthcare Provider Details

I. General information

NPI: 1699706838
Provider Name (Legal Business Name): OPTIMUM HEALTHCARE SERVICES, INC. OF ILLINOIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 02/03/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 N LINCOLN AVE STE 415
LINCOLNWOOD IL
60712-3633
US

IV. Provider business mailing address

6600 N LINCOLN AVE STE 415
LINCOLNWOOD IL
60712-3633
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-8738
  • Fax: 773-878-8753
Mailing address:
  • Phone: 773-878-8738
  • Fax: 773-878-8753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health 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: SAJID AHMED KHAN
Title or Position: OWNER
Credential:
Phone: 773-878-8738