Provider Demographics
NPI:1205258209
Name:HEALTH DELIVERY MANAGEMENT, LLC
Entity type:Organization
Organization Name:HEALTH DELIVERY MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/DIRECTO
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-563-2326
Mailing Address - Street 1:610 S MAPLE AVE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1091
Mailing Address - Country:US
Mailing Address - Phone:708-660-6822
Mailing Address - Fax:708-660-6821
Practice Address - Street 1:610 S MAPLE AVE
Practice Address - Street 2:SUITE 1600
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1091
Practice Address - Country:US
Practice Address - Phone:708-660-6822
Practice Address - Fax:708-660-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540145553336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1474573OtherNABP
IL006Medicaid