Provider Demographics
NPI:1467139998
Name:OMNI CARE CONSULTING SERVICES PLLC
Entity Type:Organization
Organization Name:OMNI CARE CONSULTING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AYODEJI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEGOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-983-9892
Mailing Address - Street 1:2735 HASSERT BLVD, STE 135, #681
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564
Mailing Address - Country:US
Mailing Address - Phone:630-863-0722
Mailing Address - Fax:
Practice Address - Street 1:2735 HASSERT BLVD, STE 135, #681
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564
Practice Address - Country:US
Practice Address - Phone:630-863-0722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-27
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty