Healthcare Provider Details

I. General information

NPI: 1073554739
Provider Name (Legal Business Name): ENDEAVOR HEALTH CLINICAL OPERATIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE G949
EVANSTON IL
60201-1718
US

IV. Provider business mailing address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2210
  • Fax: 847-570-1746
Mailing address:
  • Phone: 847-570-5230
  • Fax: 847-570-5240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number0000646
License Number StateIL

VIII. Authorized Official

Name: MR. DOUGLAS D WELDAY
Title or Position: CFO
Credential:
Phone: 847-570-5099