NPIMap

Organization Active NPI

Shiloh Hospice & Palliative Care, LLC

  • Community Based Hospice Care Agency
  • South Holland, IL
National Provider Identifier
1407467509
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
SHILOH HOSPICE & PALLIATIVE CARE, LLC
Practice address
452 E 162ND St
South Holland, IL 60473-2258
Phone
(708) 705-5841
Fax
(708) 575-3400
NPI assigned
Aug 12, 2020
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Babatunde Adeosun, APN, FNP-C, CRNA.NPI 1164892469
Title
Director
Phone
(773) 886-6894

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

Primary practice location

452 E 162ND St
South Holland, IL 60473-2258

Mailing address

452 E 162ND St
South Holland, IL 60473-2258
Phone (708) 705-5841

Other identifiers 1

IdentifierTypeStateIssuer
2003186OtherILILLINOIS HOSPICE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20201210001985 IL Part A Provider - Hospice 5092127332 Practice locations: South Holland, IL
O20220711001003 IL Part B Supplier - Clinic/Group Practice 5092127332 Receives reassigned benefits from 1 practitioner
Practice locations: South Holland, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407467509. Details of each certification follow.

Hospice certification: CCN 141710

Legal name
SHILOH HOSPICE & PALLIATIVE CARE, LLC.
Certification status
Active
Provider type (POS)
Hospice
Participating since
Jun 30, 2021
Last certification
Jun 30, 2021
Ownership / control type
Other
Organization structure
PartnershipProprietary
Incorporated
Jul 12, 2019 in IL
Enrollment address
452 E 162ND St
South Holland, IL 60473-2258

Care Compare: Hospice

Medicare Care Compare
Listed as
Shiloh Hospice & Palliative Care, LLCCCN 141710 · All quality measures
Ownership
Other
Certified
Jun 30, 2021
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2193092Shiloh Hospice & Palliative Care, L L C603 E 170TH St, South Holland, IL 60473Certificate of waiverSep 16, 2026

National Provider Directory

National Provider Directory

Locations

452 E 162nd St
South Holland, IL 60473
Phone (708) 705-5841

603 E 170th St
South Holland, IL 60473
Phone (708) 333-2211

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Fadesire O Ajuwon Individual 5% Or Greater Direct Ownership Interest Nov 16, 2020 50%
Corporate OfficerVice President Nov 16, 2020 50%
W-2 Managing EmployeeAdministrator Jul 12, 2019 50%
Babatunde Eben Adeosun Individual 5% Or Greater Direct Ownership Interest Jul 12, 2019 50%
Corporate OfficerPresident Jul 12, 2019 50%
W-2 Managing EmployeeNurse Practitioner Jul 12, 2019 50%

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1407467509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 E 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732258",
            "telephone_number": "708-705-5841",
            "fax_number": "708-575-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 E 162ND ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732258",
            "telephone_number": "708-705-5841",
            "fax_number": "708-575-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILOH HOSPICE & PALLIATIVE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "ADEOSUN",
        "authorized_official_first_name": "BABATUNDE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "773-886-6894",
        "authorized_official_credential": "APN, FNP-C, CRNA."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS HOSPICE LICENSE",
            "identifier": "2003186",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

Verify at the official NPI Registry.