Provider Demographics
NPI:1790217321
Name:INTUITIVE MEDICAL
Entity Type:Organization
Organization Name:INTUITIVE MEDICAL
Other - Org Name:INTUITIVE HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MALCOLM
Authorized Official - Middle Name:MANDELA
Authorized Official - Last Name:LEE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:708-200-4979
Mailing Address - Street 1:22232 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1119
Mailing Address - Country:US
Mailing Address - Phone:708-200-4979
Mailing Address - Fax:
Practice Address - Street 1:22232 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1119
Practice Address - Country:US
Practice Address - Phone:708-200-4979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-02
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health