Healthcare Provider Details

I. General information

NPI: 1740019892
Provider Name (Legal Business Name): KEMTOS INCORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15616 KENWOOD AVE
SOUTH HOLLAND IL
60473-1821
US

IV. Provider business mailing address

15616 KENWOOD AVE
SOUTH HOLLAND IL
60473-1821
US

V. Phone/Fax

Practice location:
  • Phone: 773-739-1190
  • Fax: 708-713-4178
Mailing address:
  • Phone: 773-739-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. OLUWAKEMI TOSIN NELSON
Title or Position: CEO
Credential: CEO
Phone: 773-739-1190