Healthcare Provider Details

I. General information

NPI: 1023528619
Provider Name (Legal Business Name): DIRECT HEALTHCARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 FRINGETREE LN
WOODRIDGE IL
60517-4653
US

IV. Provider business mailing address

1520 FRINGETREE LN
WOODRIDGE IL
60517-4653
US

V. Phone/Fax

Practice location:
  • Phone: 708-275-6192
  • Fax:
Mailing address:
  • Phone: 708-275-6192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: TANYA LE
Title or Position: PRESIDENT
Credential:
Phone: 708-275-6192