PMR Illinois Holding, LLC
Organization Active NPI Non-Pharmacy Dispensing Site · Dolton, IL
NPI 1013520113 · NPPES record last updated Oct 31, 2024
Key facts
- NPI
- 1013520113
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Non-Pharmacy Dispensing Site 332900000X
- Legal business name
- PMR ILLINOIS HOLDING, LLC
- Practice address
- 600 E Sibley Blvd
Dolton, IL 60419-2599 - Phone
- (708) 340-7400
- NPI assigned
- Aug 28, 2020
- Organization subpart
- Yes
- Parent organization (as reported)
- PMR ILLINOIS HOLDING, LLC
Authorized official
- Name
- Mary Chen
- Title
- Authorized Official
- Phone
- (305) 831-4722
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- PMR Illinois Holding LLC
- Part of
- PMR Illinois Holding LLC
Locations
600 E Sibley Blvd
Dolton, IL 60419
Phone (708) 340-7400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-Pharmacy Dispensing Site | 332900000X | Yes |
Addresses
Primary practice location
600 E Sibley Blvd
Dolton, IL 60419-2599
Mailing address
1395 NW 167TH St
Miami Gardens, FL 33169-5710
Phone (305) 628-6117
Other names
- JenCare Senior Medical Center Dolton
Other providers in Dolton, IL
- Arlene Perry
- Quinisha Perry
- Diana M. Pierce
- Pioneer Concepts Inc
- Pleasant Dental LLC
- Leonard Pollard
- Shytia Lincole Porter
- Power of Touch Massage Therpay
- Chantel Prater
- Quality Dental, Inc
All providers in Dolton, IL · Non-Pharmacy Dispensing Site in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.