Healthcare Provider Details

I. General information

NPI: 1326337155
Provider Name (Legal Business Name): TLC HEALTH SERVICES, SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2011
Last Update Date: 01/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25210 BLAKELY DR
PLAINFIELD IL
60585-6750
US

IV. Provider business mailing address

25210 BLAKELY DR
PLAINFIELD IL
60585-6750
US

V. Phone/Fax

Practice location:
  • Phone: 630-749-8905
  • Fax: 815-733-6293
Mailing address:
  • Phone: 630-749-8905
  • Fax: 815-733-6293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number041359711
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number041359711
License Number StateIL

VIII. Authorized Official

Name: MR. TIMOTHY LEE FREEMAN
Title or Position: OWNER/PRESIDENT
Credential: RN, BSN
Phone: 630-749-8905