Healthcare Provider Details

I. General information

NPI: 1619783842
Provider Name (Legal Business Name): PATHWAY HEALTHCARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2024
Last Update Date: 12/03/2024
Certification Date: 12/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 RENAISSANCE DR STE 200
PARK RIDGE IL
60068-1335
US

IV. Provider business mailing address

1400 RENAISSANCE DR STE 200
PARK RIDGE IL
60068-1335
US

V. Phone/Fax

Practice location:
  • Phone: 224-817-2273
  • Fax:
Mailing address:
  • Phone: 224-817-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ANDREW HAJDUK
Title or Position: OWNER
Credential:
Phone: 847-777-9407