Healthcare Provider Details

I. General information

NPI: 1225265390
Provider Name (Legal Business Name): ROYAL HOME HEALTH SERVICES,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2009
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4645 147TH ST
MIDLOTHIAN IL
60445-2524
US

IV. Provider business mailing address

4645 147TH ST
MIDLOTHIAN IL
60445-2524
US

V. Phone/Fax

Practice location:
  • Phone: 708-535-0277
  • Fax: 708-535-2995
Mailing address:
  • Phone: 708-535-0277
  • Fax: 708-535-2995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1011058
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number1011058
License Number StateIL

VIII. Authorized Official

Name: ABAYOMI SAMSON JOEL
Title or Position: PRESIDENT
Credential: BACHELOR DEGREE
Phone: 773-719-5863