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General NPI Number Information
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NPI Number | 1326382748
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Entity Type | Organization
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Legal Business Name | DM ENTERPRISES GROUP, INC.
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 4903 FOREST AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3509
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Country | US
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Telephone | 630-515-1185
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Fax | 630-757-0172
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Provider Business Mailing Address
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Address Line | 4903 FOREST AVE
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3509
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Country | US
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Telephone | 630-515-1185
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Fax | 630-757-0172
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Authorized Official
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Title or Position | OWNER
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Name | MR. MICHAEL GONZALEZ
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Credential | M.A., C.S.A.
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Telephone | 630-515-1185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State | IL
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