Provider Demographics
NPI:1992910558
Name:SPECTRUM NURSES INCORPORATED
Entity type:Organization
Organization Name:SPECTRUM NURSES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BERKO
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-771-9069
Mailing Address - Street 1:481 W BOUGHTON RD # 400
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-1821
Mailing Address - Country:US
Mailing Address - Phone:630-771-9069
Mailing Address - Fax:630-771-9075
Practice Address - Street 1:481 W BOUGHTON RD # 400
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-1821
Practice Address - Country:US
Practice Address - Phone:630-771-9069
Practice Address - Fax:630-771-9075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010235251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health