Interserve Home Nursing Services LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

INTERSERVE HOME NURSING SERVICES LLC

Practice address

11723 Glenn Cir
Plainfield, IL 60585-5794

Phone

(773) 290-0245

Fax

(630) 296-6149

NPI assigned

Jun 2, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Olubukola Okanlawon

Title

Agency Manager

Phone

(773) 290-0245

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622678400000",
    "number": "1003482753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11723 GLENN CIR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855794",
            "telephone_number": "773-290-0245",
            "fax_number": "630-296-6149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11723 GLENN CIR",
            "city": "PLAINFIELD",
            "state": "IL",
            "postal_code": "605855794",
            "telephone_number": "773-290-0245",
            "fax_number": "630-296-6149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSERVE HOME NURSING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A",
        "authorized_official_last_name": "OKANLAWON",
        "authorized_official_first_name": "OLUBUKOLA",
        "authorized_official_title_or_position": "AGENCY MANAGER",
        "authorized_official_telephone_number": "773-290-0245"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.