Healthcare Provider Details

I. General information

NPI: 1780198176
Provider Name (Legal Business Name): HEALTH DELIVERY MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2017
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S. MAPLE AVE. SUITE 1200
OAK PARK IL
60304-1091
US

IV. Provider business mailing address

PO BOX 88273
CHICAGO IL
60680-1273
US

V. Phone/Fax

Practice location:
  • Phone: 708-660-6200
  • Fax: 708-660-6199
Mailing address:
  • Phone: 312-563-3225
  • Fax: 312-563-3223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number054015422
License Number StateIL

VIII. Authorized Official

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