Provider Demographics
NPI:1689358582
Name:EVERCARE HOME HEALTH LLC
Entity Type:Organization
Organization Name:EVERCARE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KAZEEM
Authorized Official - Middle Name:OLAKUNLE
Authorized Official - Last Name:AJEIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-925-0433
Mailing Address - Street 1:14810 CICERO AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-1460
Mailing Address - Country:US
Mailing Address - Phone:708-925-0433
Mailing Address - Fax:
Practice Address - Street 1:14810 CICERO AVE STE 2C
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-1460
Practice Address - Country:US
Practice Address - Phone:708-925-0433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty