Healthcare Provider Details

I. General information

NPI: 1053125534
Provider Name (Legal Business Name): THRONE OF GRACE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21861 W KENTWOOD DR
PLAINFIELD IL
60544-7050
US

IV. Provider business mailing address

21861 W KENTWOOD DR
PLAINFIELD IL
60544-7050
US

V. Phone/Fax

Practice location:
  • Phone: 815-909-4180
  • Fax:
Mailing address:
  • Phone: 815-909-4180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHINWE BEKEE
Title or Position: CEO
Credential: RN
Phone: 815-909-4180