Provider Demographics
NPI:1063000842
Name:INSPIRED GRACE HEALTHCARE INC
Entity Type:Organization
Organization Name:INSPIRED GRACE HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:IDOWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-484-0596
Mailing Address - Street 1:9753 SCHAFFNER DR
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-0080
Mailing Address - Country:US
Mailing Address - Phone:847-962-7840
Mailing Address - Fax:
Practice Address - Street 1:1051 E MAIN ST STE 212
Practice Address - Street 2:
Practice Address - City:EAST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-2455
Practice Address - Country:US
Practice Address - Phone:224-484-0596
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies