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Organization

SACRED SPACE IN HOME HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PHYLLIS EGGLESTON DNP (NURSE PRACTITIONER)
(773) 791-0019
Entity
Organization

Contact information

Practice address
10159 S VERNON AVE, CHICAGO, IL 60628-2235
(773) 791-0019
Mailing address
10159 S VERNON AVE, CHICAGO, IL 60628-2235

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary

Other

Enumeration date
11/27/2025
Last updated
11/27/2025
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