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General NPI Number Information
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NPI Number | 1407467509
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Entity Type | Organization
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Legal Business Name | SHILOH HOSPICE & PALLIATIVE CARE, LLC
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 603 E 170TH ST
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-3408
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Country | US
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Telephone | 708-705-5841
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Fax | 708-575-3400
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Provider Business Mailing Address
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Address Line | 603 E 170TH ST
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473-3408
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Country | US
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Telephone | 773-886-6894
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | BABATUNDE ADEOSUN
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Credential | APN, FNP-C, CRNA.
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Telephone | 773-886-6894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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