Healthcare Provider Details

I. General information

NPI: 1275040651
Provider Name (Legal Business Name): COMPASSIONATE HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2018
Last Update Date: 01/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5747 AMLIN TER
MATTESON IL
60443-2934
US

IV. Provider business mailing address

5747 AMLIN TER
MATTESON IL
60443-2934
US

V. Phone/Fax

Practice location:
  • Phone: 312-405-8536
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: UMEKO JONES
Title or Position: CEO
Credential: FNP-BC
Phone: 312-405-8536