Provider Demographics
NPI:1659172377
Name:CAREOPTUM HEALTHCARE SERVICES LLC
Entity type:Organization
Organization Name:CAREOPTUM HEALTHCARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENCY ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EZINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBONU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-631-6106
Mailing Address - Street 1:2851 189TH ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-3415
Mailing Address - Country:US
Mailing Address - Phone:708-631-6106
Mailing Address - Fax:
Practice Address - Street 1:2851 189TH ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-3415
Practice Address - Country:US
Practice Address - Phone:708-631-6106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care