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General NPI Number Information
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NPI Number | 1083714026
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Entity Type | Organization
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Legal Business Name | D K HEALTHCARE SERVICES,INC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 3114 W 95TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2405
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Country | US
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Telephone | 708-229-2400
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Fax | 708-229-2404
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Provider Business Mailing Address
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Address Line | 3114 W 95TH STREET
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City | EVERGREEN PARK
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State | IL
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Zip | 60805
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Country | US
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Telephone | 708-229-2400
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Fax | 708-229-2404
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Authorized Official
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Title or Position | CEO/ASSOCIATE ADMINISTOR
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Name | KHALIL MEMON
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Credential |
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Telephone | 708-229-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 1010294
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License Number State | IL
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