Provider Demographics
NPI:1083335723
Name:MAJESTIC HEALTH SERVICES INC.
Entity Type:Organization
Organization Name:MAJESTIC HEALTH SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADEYINKA
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:773-807-2175
Mailing Address - Street 1:3525 W PETERSON AVE STE 430
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3317
Mailing Address - Country:US
Mailing Address - Phone:920-355-2939
Mailing Address - Fax:773-302-1076
Practice Address - Street 1:1826 SIMPSON ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3042
Practice Address - Country:US
Practice Address - Phone:773-807-2175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing CareGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty