Provider Demographics
NPI:1205683992
Name:SUPREME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:SUPREME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADENIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSHIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:708-275-0928
Mailing Address - Street 1:575 N FALLS CIR
Mailing Address - Street 2:
Mailing Address - City:PINGREE GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-5438
Mailing Address - Country:US
Mailing Address - Phone:708-275-0928
Mailing Address - Fax:
Practice Address - Street 1:575 N FALLS CIR
Practice Address - Street 2:
Practice Address - City:PINGREE GROVE
Practice Address - State:IL
Practice Address - Zip Code:60140-5438
Practice Address - Country:US
Practice Address - Phone:708-275-0928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-01
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty