Provider Demographics
NPI:1841612843
Name:HEALTH DELIVERY MANAGMENT, LLC
Entity type:Organization
Organization Name:HEALTH DELIVERY MANAGMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:KEMPER
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:312-563-2326
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 1:1520 W HARRISON ST RM 9115
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3106
Practice Address - Country:US
Practice Address - Phone:312-563-2363
Practice Address - Fax:312-942-2330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-09
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540116333336C0003X, 3336C0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1465916OtherNABP
IL003Medicaid
1465916OtherNABP