Provider Demographics
NPI:1265856710
Name:ROYAL STAFF INC
Entity Type:Organization
Organization Name:ROYAL STAFF INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN
Authorized Official - Prefix:MRS
Authorized Official - First Name:OMOTUNDE
Authorized Official - Middle Name:OMOLABAKE
Authorized Official - Last Name:ADENIJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-909-3016
Mailing Address - Street 1:10934 S BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3752
Mailing Address - Country:US
Mailing Address - Phone:773-909-3016
Mailing Address - Fax:
Practice Address - Street 1:10934 S BEVERLY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3752
Practice Address - Country:US
Practice Address - Phone:773-909-3016
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043085337314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility