Provider Demographics
NPI:1437857612
Name:LOTUSCARE SERVICES LLC
Entity type:Organization
Organization Name:LOTUSCARE SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:EVIDENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:EGUAKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-917-4600
Mailing Address - Street 1:4001 W DEVON AVE STE 310E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-4538
Mailing Address - Country:US
Mailing Address - Phone:773-917-4600
Mailing Address - Fax:872-266-0325
Practice Address - Street 1:4001 W DEVON AVE STE 310E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-4538
Practice Address - Country:US
Practice Address - Phone:773-917-4600
Practice Address - Fax:872-266-0325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5223825Medicaid