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General NPI Number Information
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NPI Number | 1619158011
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Entity Type | Organization
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Legal Business Name | DINAMIC HEALTH CARE, LLC
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 09/12/2018
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Provider Practice Location Address
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Address Line | 353 W LINCOLN HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2555
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Country | US
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Telephone | 708-832-9908
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Fax | 708-832-9935
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Provider Business Mailing Address
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Address Line | 353 W LINCOLN HWY
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-2555
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Country | US
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Telephone | 708-832-9908
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Fax | 708-832-9935
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | VERNIE N NELSON
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Credential | RN
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Telephone | 708-983-4623
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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 | 1010797
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License Number State | IL
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