Healthcare Provider Details

I. General information

NPI: 1831901255
Provider Name (Legal Business Name): SALLY HEALTH CONSULTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 W SUTTON PL UNIT A
MONEE IL
60449-8131
US

IV. Provider business mailing address

5410 W MAIN ST UNIT A
MONEE IL
60449-8101
US

V. Phone/Fax

Practice location:
  • Phone: 312-802-9646
  • Fax: 866-439-2402
Mailing address:
  • Phone: 312-802-9646
  • Fax: 866-439-2402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ISHMAEL AMU
Title or Position: CHIEF OPERATING OFFICER
Credential: MD
Phone: 312-802-9646