Healthcare Provider Details

I. General information

NPI: 1467166876
Provider Name (Legal Business Name): DIGITAL CARE TEAM OF AL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2023
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOUTHBRIDGE PKWY # 650
BIRMINGHAM AL
35209-1317
US

IV. Provider business mailing address

343 N WOOD DALE RD # 201A
WOOD DALE IL
60191-1578
US

V. Phone/Fax

Practice location:
  • Phone: 312-600-5061
  • Fax:
Mailing address:
  • Phone: 312-600-5061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: WAJAHATUDDIN MACCI
Title or Position: OWNER
Credential:
Phone: 312-600-5061