Meddoc 40 LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

MEDDOC 40 LLC

Practice address

5113 S Harper Ave
Chicago, IL 60615-4119

Phone

(708) 567-1071

NPI assigned

Dec 4, 2024

Organization subpart

No

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

Authorized official

Name

Tonesia Rouse, MHA FACHE

Title

Owner

Phone

(708) 567-1971

Specialties & licenses 6

Addresses

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

{
    "created_epoch": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1942016092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 W 86TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523933",
            "telephone_number": "773-937-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5113 S HARPER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154119",
            "telephone_number": "708-567-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDDOC 40 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "ROUSE",
        "authorized_official_first_name": "TONESIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-567-1971",
        "authorized_official_credential": "MHA FACHE"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medcare Home Health Services, Inc.
• Medcare, Inc.
• Medcentrix Inc
• Medconcept Supply
• Medcounsel Pharmacy Corp.
• Irena Medenica, M.D
• Mae Medenilla, PHARM.D
• Mark Mederich
• Rachel Medernach, M.D.
• Christopher Medero, RN

• Health Service Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; 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.