Provider Demographics
NPI:1962877969
Name:ROYAL COMPASSIONATE HOME HEALTH LLC
Entity type:Organization
Organization Name:ROYAL COMPASSIONATE HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOPELOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:FATUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-523-4742
Mailing Address - Street 1:1005 HEATHROW CT
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-7774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1005 HEATHROW CT
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-7774
Practice Address - Country:US
Practice Address - Phone:312-523-4742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011561251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health