Healthcare Provider Details

I. General information

NPI: 1467787481
Provider Name (Legal Business Name): QUALITYLIFE HEALTHCARE,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2009
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15525 S PARK AVE SUITE 103A
SOUTH HOLLAND IL
60473-1308
US

IV. Provider business mailing address

15525 S PARK AVE STE 103A
SOUTH HOLLAND IL
60473-1379
US

V. Phone/Fax

Practice location:
  • Phone: 708-331-4214
  • Fax: 708-331-4216
Mailing address:
  • Phone: 708-331-4214
  • Fax: 708-331-4216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1010971
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: OLAJIDE DAVID ADEWALE
Title or Position: AGENCY SUPERVISOR
Credential:
Phone: 708-331-4214