Provider Demographics
NPI:1831906809
Name:ESSENTIAL HEALTH SERVICES 1 LLC
Entity type:Organization
Organization Name:ESSENTIAL HEALTH SERVICES 1 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWOYEMI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:773-621-7034
Mailing Address - Street 1:8 FORSYTHIA CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2032
Mailing Address - Country:US
Mailing Address - Phone:773-621-7034
Mailing Address - Fax:
Practice Address - Street 1:8 FORSYTHIA CT
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-2032
Practice Address - Country:US
Practice Address - Phone:773-621-7034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care