Deta Corporation

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

DETA CORPORATION

Practice address

3259 Holeman Ave
South Chicago Heights, IL 60411-5515

Phone

(708) 756-7440

Fax

(708) 756-7680

NPI assigned

May 28, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Ermelinda P. Djondo, COLLEGE GRADUATE

Title

Vice-President

Phone

(708) 756-7440

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245287721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3259 HOLEMAN AVE",
            "city": "SOUTH CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604115515",
            "telephone_number": "708-756-7440",
            "fax_number": "708-756-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3259 HOLEMAN AVE",
            "city": "SOUTH CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604115515",
            "telephone_number": "708-756-7440",
            "fax_number": "708-756-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETA CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DJONDO",
        "authorized_official_first_name": "ERMELINDA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "708-756-7440",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COLLEGE GRADUATE"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martynas Aukstuolis, LCSW
• Jennifer Lynn Barrett, PHARMD
• Yogunda Cochran, RN
• Jonathan Michael Czyscon, DMD
• Ginger Dean, APRN
• Dawn Marie Foushi
• Glamour Dental South Chicago Heights LLC
• Sophia Marie Goncher
• Ahmad Hasan
• Integrity Olive Trees LLC

• Durable Medical Equipment & Medical Supplies in South Chicago Heights, IL
• Providers in South Chicago Heights, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.