Healthcare Provider Details

I. General information

NPI: 1295597110
Provider Name (Legal Business Name): GENTLE GUARDIANS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 01/27/2024
Certification Date: 01/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E GOLF RD STE 950
SCHAUMBURG IL
60173-5034
US

IV. Provider business mailing address

1900 E GOLF RD STE 950
SCHAUMBURG IL
60173-5034
US

V. Phone/Fax

Practice location:
  • Phone: 312-724-5007
  • Fax:
Mailing address:
  • Phone: 773-798-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: ONYINYECHI PRECIOUS ELEONU
Title or Position: CEO
Credential:
Phone: 773-798-8450