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General NPI Number Information
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NPI Number | 1497171276
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Entity Type | Organization
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Legal Business Name | MEDTEC HEALTHCARE & PRIVATE DUTY, LLC
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Dates
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Enumeration Date | 03/17/2014
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 47 W DUNDEE RD 1S
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City | WHEELING
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State | IL
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Zip | 60090-4894
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Country | US
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Telephone | 847-520-9695
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Fax | 847-520-9450
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Provider Business Mailing Address
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Address Line | 47 W DUNDEE RD STE 2SW
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City | WHEELING
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State | IL
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Zip | 60090-4866
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Country | US
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Telephone | 847-229-1088
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Fax | 847-470-4289
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | YI WONG
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Credential |
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Telephone | 847-663-5511
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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 |
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