DIVERSEY HEALTH CARE CLINIC INC NPI 1225416308

NPI Information

NPI: 1225416308
Provider Name: DIVERSEY HEALTH CARE CLINIC INC

Doing Business As: DIVERSEY HEALTHCARE CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
4911 W DIVERSEY AVE
CHICAGO, IL
ZIP 60639
Phone: (773) 237-3100
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DIVERSEY HEALTH CARE CLINIC INC is a primary care clinic center in Chicago, IL. DIVERSEY HEALTH CARE CLINIC INC NPI is 1225416308. The provider is registered as an organization entity type.
The provider Is Doing Business As Diversey Healthcare Clinic.

The provider's business location address is:

4911 W DIVERSEY AVE
CHICAGO, IL
ZIP 60639-705
Phone: (773) 237-3100
Fax: (855) 299-4948

The provider's authorized official is Ricardo Machado .
The authorized official title is President and has the following contact phone number (708) 738-7351.

The enumeration date for this NPI number is 5/11/2015 and was last updated on 8/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	036.120095	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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