Healthcare Provider Details

I. General information

NPI: 1629845383
Provider Name (Legal Business Name): MEDSENSE RTM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 FINLEY RD STE 202
DOWNERS GROVE IL
60515-1039
US

IV. Provider business mailing address

2801 FINLEY RD STE 202
DOWNERS GROVE IL
60515-1039
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-2053
  • Fax:
Mailing address:
  • Phone: 206-486-2053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2278H0200X
TaxonomyHome Health Certified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code2083C0008X
TaxonomyClinical Informatics Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH DEARIE
Title or Position: OWNER, PHYSICIAN
Credential: MD
Phone: 206-486-2053