Provider Demographics
NPI:1013105659
Name:HOPKINS NURSING CONSULTANTS, LLC
Entity Type:Organization
Organization Name:HOPKINS NURSING CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERVIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, FNP
Authorized Official - Phone:708-748-2055
Mailing Address - Street 1:514 ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-1076
Mailing Address - Country:US
Mailing Address - Phone:708-748-2055
Mailing Address - Fax:708-748-2257
Practice Address - Street 1:514 ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-1076
Practice Address - Country:US
Practice Address - Phone:708-748-2055
Practice Address - Fax:708-748-2257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILPENDING251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL126772-00OtherIDHR BIDDER #