Provider Demographics
NPI:1972336618
Name:NEWPATH MEDICAL SERVICES AND STAFFING AGENCY, LLC
Entity type:Organization
Organization Name:NEWPATH MEDICAL SERVICES AND STAFFING AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:BENEDICTA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAGBEGI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:708-692-1699
Mailing Address - Street 1:21243 OLD NORTH CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3014
Mailing Address - Country:US
Mailing Address - Phone:708-692-1699
Mailing Address - Fax:
Practice Address - Street 1:7924 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4360
Practice Address - Country:US
Practice Address - Phone:708-692-1699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service