Provider Demographics
NPI:1235735622
Name:MAGNIFICENT HEALTHCARE AND CPR INC.
Entity Type:Organization
Organization Name:MAGNIFICENT HEALTHCARE AND CPR INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:OKODUA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APN, RN, FNP-BC
Authorized Official - Phone:312-685-5243
Mailing Address - Street 1:6443 N HOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5850
Mailing Address - Country:US
Mailing Address - Phone:773-856-3203
Mailing Address - Fax:
Practice Address - Street 1:2046 W DEVON AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-2241
Practice Address - Country:US
Practice Address - Phone:773-856-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Multi-Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty