Healthcare Provider Details

I. General information

NPI: 1285926949
Provider Name (Legal Business Name): DESTINY HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10031 W ROOSEVELT RD STE 100
WESTCHESTER IL
60154-2669
US

IV. Provider business mailing address

10031 W ROOSEVELT RD STE 100
WESTCHESTER IL
60154-2669
US

V. Phone/Fax

Practice location:
  • Phone: 708-450-1920
  • Fax: 708-450-1921
Mailing address:
  • Phone: 708-450-1920
  • Fax: 708-450-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1011943
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number3001648
License Number StateIL

VIII. Authorized Official

Name: MR. SYED NAJAMUDDIN
Title or Position: PRESIDENT
Credential:
Phone: 708-450-1920