Provider Demographics
NPI:1053830828
Name:CARING SHEPHERDS HEALTH CARE INC
Entity Type:Organization
Organization Name:CARING SHEPHERDS HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FOLARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OPAKUNLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN FNP
Authorized Official - Phone:708-331-4214
Mailing Address - Street 1:15525 S PARK AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1379
Mailing Address - Country:US
Mailing Address - Phone:708-331-4214
Mailing Address - Fax:708-331-4216
Practice Address - Street 1:15525 SOUTH PARK AVE
Practice Address - Street 2:SUITE 103B
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473
Practice Address - Country:US
Practice Address - Phone:708-331-4214
Practice Address - Fax:708-331-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4000533253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4000533OtherIDPH LICENSE NUMBER