Provider Demographics
NPI:1891444212
Name:TRIPLE K HEALTHCARE SERVICES LLC
Entity Type:Organization
Organization Name:TRIPLE K HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLADIPO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:773-355-1336
Mailing Address - Street 1:850 BURNHAM AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-4707
Mailing Address - Country:US
Mailing Address - Phone:773-355-1336
Mailing Address - Fax:
Practice Address - Street 1:850 BURNHAM AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-4707
Practice Address - Country:US
Practice Address - Phone:773-355-1336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty