NPIMap

Organization Active NPI

Medtec Healthcare & Private Duty, LLC

  • In Home Supportive Care Agency
  • Morton Grove, IL
National Provider Identifier
1114270246
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
MEDTEC HEALTHCARE & PRIVATE DUTY, LLC
Practice address
9242 Waukegan Rd
Morton Grove, IL 60053-2101
Phone
(847) 470-4701
Fax
(847) 470-9289
NPI assigned
Oct 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Yi Wong
Title
Vice President
Phone
(847) 663-5511

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Adult Day Care Clinic/Center 261QA0600X
HomemakerGroup: 193400000X SINGLE SPECIALTY GROUP 376J00000X

Addresses

Primary practice location

9242 Waukegan Rd
Morton Grove, IL 60053-2101

Mailing address

9242 Waukegan Rd
Morton Grove, IL 60053-2101
Phone (847) 470-4701

National Provider Directory

National Provider Directory
Tax ID family
Medtec Healthcare Private Duty LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9242 Waukegan Rd
Morton Grove, IL 60053
Phone (847) 470-4701

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1114270246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9242 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532101",
            "telephone_number": "847-470-4701",
            "fax_number": "847-470-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9242 WAUKEGAN RD",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600532101",
            "telephone_number": "847-470-4701",
            "fax_number": "847-470-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTEC HEALTHCARE & PRIVATE DUTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "YI",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "847-663-5511"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.