Provider Demographics
NPI:1750884714
Name:NIKIWILL INC.
Entity type:Organization
Organization Name:NIKIWILL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINN
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:630-219-4160
Mailing Address - Street 1:1300 IROQUOIS AVE STE 132
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-1112
Mailing Address - Country:US
Mailing Address - Phone:630-219-4160
Mailing Address - Fax:
Practice Address - Street 1:1300 IROQUOIS AVE STE 132
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-1112
Practice Address - Country:US
Practice Address - Phone:630-219-4160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3001211OtherIDPH HOME SERVICES LICENSE