Healthcare Provider Details

I. General information

NPI: 1588516132
Provider Name (Legal Business Name): ELIANAK CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22307 CENTRAL PARK AVE
PARK FOREST IL
60466-1967
US

IV. Provider business mailing address

22307 CENTRAL PARK AVE
PARK FOREST IL
60466-1967
US

V. Phone/Fax

Practice location:
  • Phone: 908-279-9612
  • Fax:
Mailing address:
  • Phone: 908-279-9612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: AKINDELE OGUNLEYE
Title or Position: PRESIDENT
Credential:
Phone: 908-279-9612