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General NPI Number Information
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NPI Number | 1649616129
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Entity Type | Organization
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Legal Business Name | PEKO HEALTHCARE AND CONSULTING SERVICES, INC.
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Dates
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Enumeration Date | 05/10/2013
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 526 E 87TH ST
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City | CHICAGO
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State | IL
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Zip | 60619-6045
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Country | US
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Telephone | 312-912-7672
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Fax | 708-747-1343
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Provider Business Mailing Address
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Address Line | 4986 GIBSON ST
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City | MATTESON
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State | IL
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Zip | 60443-3023
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Country | US
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Telephone | 773-912-7672
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Fax | 708-747-1343
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Authorized Official
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Title or Position | PRESIDENT/AGENCY ADMINISTRATOR
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Name | MR. SETH K OWUSU
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Credential | MPH, MBA
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Telephone | 708-539-9014
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 4000342
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 3000756
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1011433
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License Number State | IL
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