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Organization
PROVIDER HEALTHCARE SERVICES, INC
Active
Organization
PROVIDER HEALTHCARE SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SULAIMON K OLADIPO (PRESIDENT)
(773) 301-8464
Entity
Organization
Contact information
Practice address
555 SOUTH SCHUYLER, SUITE 275, KANKAKEE, IL 60901
(773) 301-8464
(773) 530-2643
Mailing address
555 S SCHUYLER AVE, SUITE 275, KANKAKEE, IL 60901-5146
(773) 301-8464
(773) 530-2643
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011663
IL
Other
Enumeration date
10/24/2014
Last updated
10/27/2014
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