Healthcare Provider Details

I. General information

NPI: 1194699314
Provider Name (Legal Business Name): FAMILY PARAMOUNT PALLIATIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2025
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W 5TH AVE STE 208B
NAPERVILLE IL
60563-4936
US

IV. Provider business mailing address

800 W 5TH AVE STE 208B
NAPERVILLE IL
60563-4936
US

V. Phone/Fax

Practice location:
  • Phone: 331-305-5843
  • Fax: 331-258-8300
Mailing address:
  • Phone: 331-305-5843
  • Fax: 331-258-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: BELUOLISA OKONKWO
Title or Position: ADMINISTRATOR
Credential:
Phone: 331-305-5843