Healthcare Provider Details

I. General information

NPI: 1285475509
Provider Name (Legal Business Name): IMAGO DEI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17732 OAK PARK AVE STE J
TINLEY PARK IL
60477-2064
US

IV. Provider business mailing address

22835 MARINA DR
PLAINFIELD IL
60585-7945
US

V. Phone/Fax

Practice location:
  • Phone: 773-255-8885
  • Fax:
Mailing address:
  • Phone: 773-255-8885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES E DUKES
Title or Position: CEO
Credential: MA,MATS,D.MIN
Phone: 773-255-8885