Provider Demographics
NPI:1235759762
Name:SIMMS, HELENA C
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:C
Last Name:SIMMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9249 S CICERO AVE UNIT 344
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60454-4916
Mailing Address - Country:US
Mailing Address - Phone:883-332-2011
Mailing Address - Fax:
Practice Address - Street 1:16237 HONORE AVE
Practice Address - Street 2:
Practice Address - City:MARKHAM
Practice Address - State:IL
Practice Address - Zip Code:60428-5713
Practice Address - Country:US
Practice Address - Phone:708-553-9007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101-10682246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy