Healthcare Provider Details

I. General information

NPI: 1831082965
Provider Name (Legal Business Name): RELATYV MOBILE MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US

IV. Provider business mailing address

4140 E BASELINE RD STE 101 STE 101
MESA AZ
85206-4413
US

V. Phone/Fax

Practice location:
  • Phone: 830-832-9703
  • Fax: 877-285-0477
Mailing address:
  • Phone: 830-832-9703
  • Fax: 877-285-0477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: JANICE A COMPTON
Title or Position: CONTRACT MANAGER
Credential:
Phone: 830-832-9703