Direct Alpha Health Corp

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

004.002239 Issued in IL

Legal business name

DIRECT ALPHA HEALTH CORP

Practice address

19900 Governors Dr Ste 16
Olympia Fields, IL 60461-1059

Phone

(708) 283-2511

NPI assigned

Jun 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. J B Tate

Title

President

Phone

(708) 283-2511

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1851551048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19900 GOVERNORS DR STE 16",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611059",
            "telephone_number": "708-283-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 GOVERNORS DR STE 16",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611059",
            "telephone_number": "708-283-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT ALPHA HEALTH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "J B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-283-2511",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "IL",
            "license": "004.002239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aradhika Deswal, MD
• Sangeet Dhillon-Jhattu, M.D.
• Dialysis Care Center Olympia Fields LLC
• Emily Ann Diekemper, COTA/L
• Joseph Tyler Dillon, DO
• Brittany Marie Dixon, M.D.
• Melissa Kirstie Cruz Dizon, PTA
• Ana Djordjevich, RPH
• Dzhastyn Dkhillon, MD
• Debbie P Dobias, PTA

• Non-Pharmacy Dispensing Site in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; 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.