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General NPI Number Information
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NPI Number | 1093054983
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Entity Type | Organization
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Legal Business Name | M & D HEALTH CARE, INC.
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 02/12/2013
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Provider Practice Location Address
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Address Line | 3525 W PETERSON AVE SUITE T-21
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City | CHICAGO
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State | IL
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Zip | 60659-3324
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Country | US
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Telephone | 773-583-1433
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Fax | 773-583-1435
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Provider Business Mailing Address
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Address Line | 3525 W PETERSON AVE SUITE T-21
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City | CHICAGO
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State | IL
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Zip | 60659-3324
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Country | US
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Telephone | 773-583-1433
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Fax | 773-583-1435
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. JOSEFINA P CACAL
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Credential | RN
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Telephone | 773-294-8221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 5902-579-1
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License Number State | IL
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