Healthcare Provider Details

I. General information

NPI: 1841612843
Provider Name (Legal Business Name): HEALTH DELIVERY MANAGMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2014
Last Update Date: 06/20/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 W HARRISON ST RM 9115
CHICAGO IL
60607-3106
US

IV. Provider business mailing address

PO BOX 88273
CHICAGO IL
60680-1273
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-2363
  • Fax: 312-942-2330
Mailing address:
  • Phone: 312-563-3225
  • Fax: 312-563-3223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number054011633
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number054011633
License Number StateIL

VIII. Authorized Official

Name: MATTHEW KEMPER
Title or Position: SECRETARY/DIRECTOR
Credential: PHARMD
Phone: 312-563-2326