Provider Demographics
NPI:1952312456
Name:HEALTH DELIVERY MANAGEMENT L L C
Entity Type:Organization
Organization Name:HEALTH DELIVERY MANAGEMENT L L C
Other - Org Name:HOME INFUSION SOLUTIONS
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:312-563-3225
Mailing Address - Fax:312-563-3223
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:STE 1200
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-660-6200
Practice Address - Fax:708-660-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL0540154223336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1477733OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1477733OtherNCPDP PROVIDER IDENTIFICATION NUMBER
IL=========007Medicaid