Healthcare Provider Details

I. General information

NPI: 1376243055
Provider Name (Legal Business Name): GENTLE HANDS PHLEBOTOMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 03/09/2023
Certification Date: 03/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5015 N LAWNDALE AVE
CHICAGO IL
60625-9398
US

IV. Provider business mailing address

5015 N LAWNDALE AVE
CHICAGO IL
60625-9398
US

V. Phone/Fax

Practice location:
  • Phone: 312-282-5725
  • Fax:
Mailing address:
  • Phone: 312-282-5725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246R00000X
TaxonomyPathology Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: DARLENE DECENA
Title or Position: OWNER/PRESIDENT
Credential: RN
Phone: 312-282-5725