Provider Demographics
NPI:1851639371
Name:HEALTH DELIVERY MANAGEMENT, LLC
Entity Type:Organization
Organization Name:HEALTH DELIVERY MANAGEMENT, LLC
Other - Org Name:RUSH LISLE INFUSION PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-942-2852
Mailing Address - Street 1:PO BOX 88273
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-1273
Mailing Address - Country:US
Mailing Address - Phone:312-563-3223
Mailing Address - Fax:312-563-3223
Practice Address - Street 1:430 WARRENVILLE ROAD
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532
Practice Address - Country:US
Practice Address - Phone:630-724-5045
Practice Address - Fax:630-724-8704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540181133336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy