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General NPI Number Information
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NPI Number | 1194669416
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Entity Type | Organization
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Legal Business Name | DOVER HEALTH PALLIATIVE CARE IL, LLC
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Dates
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Enumeration Date | 04/16/2026
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Last Update Date | 04/16/2026
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Provider Practice Location Address
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Address Line | 3333 75TH ST # LL20
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City | WOODRIDGE
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State | IL
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Zip | 60517-2730
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Country | US
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Telephone | 815-513-8056
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Fax |
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Provider Business Mailing Address
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Address Line | 300 HUNTER AVE STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2094
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. FREDERICK GROSSMAN
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Credential |
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Telephone | 402-960-3472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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