MEDICARE: HEALTH DELIVERY MANAGEMENT L L C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0002X	Clinic Pharmacy
2	3336C0003X	Community/Retail Pharmacy	54011624	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1465904	OTHER	IL	NABP CODE

General Provider Information

NPI Number	:	1871673079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTH DELIVERY MANAGEMENT L L C

Provider Business Mailing Address
First Line	:	1725 W HARRISON ST
Second Line	:	SUITE 418
City	:	CHICAGO
State	:	IL
Zip	:	60612-3841
Country	:	US
Telephone Number	:	312-563-2093
Fax Number	:	312-942-5503

Provider Business Practice Location Address
First Line	:	1725 W HARRISON ST
Second Line	:	SUITE 418
City	:	CHICAGO
State	:	IL
Zip	:	60612-3841
Country	:	US
Telephone Number	:	312-563-2245
Fax Number	:	312-942-5503

Authorized Official
Title or Position	:	SECRETARY/DIRECTOR
Name	:	MATTHEW KEMPER
Credential	:	PHARMD
Telephone Number	:	312-563-2326

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/16/2024

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