Healthcare Provider Details

I. General information

NPI: 1063237311
Provider Name (Legal Business Name): AVID CARE DEVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17465 KEDZIE AVE
HAZEL CREST IL
60429-1632
US

IV. Provider business mailing address

17465 KEDZIE AVE
HAZEL CREST IL
60429-1632
US

V. Phone/Fax

Practice location:
  • Phone: 708-953-9527
  • Fax: 708-786-0066
Mailing address:
  • Phone: 708-953-9527
  • Fax: 708-786-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ANAM BUTT
Title or Position: OWNER
Credential:
Phone: 708-887-7329