Provider Demographics
NPI:1437857612
Name:LOTUS CARE SERVICES LLC
Entity Type:Organization
Organization Name:LOTUS CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:AYOTUNDE
Authorized Official - Middle Name:AKINTUNDE
Authorized Official - Last Name:OKE
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:312-678-2920
Mailing Address - Street 1:2521 RIDGE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-2792
Mailing Address - Country:US
Mailing Address - Phone:312-678-2920
Mailing Address - Fax:
Practice Address - Street 1:2521 RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2792
Practice Address - Country:US
Practice Address - Phone:312-678-2920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5223825Medicaid