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NPI Code Detail

MEDICARE: DINAMIC HEALTH CARE, LLC

MEDICARE: DINAMIC HEALTH CARE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency1010797IL

General Provider Information

NPI Number : 1619158011
Entity Type Code : Organization
Provider Name (Legal Business Name) : DINAMIC HEALTH CARE, LLC
Provider Business Mailing Address
First Line : 353 W LINCOLN HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2555
Country : US
Telephone Number : 708-832-9908
Fax Number : 708-832-9935
Provider Business Practice Location Address
First Line : 353 W LINCOLN HWY
Second Line :
City : CHICAGO HEIGHTS
State : IL
Zip : 60411-2555
Country : US
Telephone Number : 708-832-9908
Fax Number : 708-832-9935
Authorized Official
Title or Position : ADMINISTRATOR
Name : VERNIE N NELSON
Credential : RN
Telephone Number : 708-983-4623
Provider Enumeration Date : 11/14/2007
Last Update Date : 09/12/2018

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Directions to “DINAMIC HEALTH CARE, LLC ” Practice Location

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