DISENTANGLE LLC (NPI# 1134650484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134650484 |
| Entity Type | Organization |
| Organization Name | DISENTANGLE LLC |
| Practice Address |
11104 S Kedzie Ave Chicago IL 60655-2330 |
| Practice Telephone | 7085816487 |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2017-03-27 |
| Authorized Official Name | JACLYN O'CONNELL (OWNER) |
| Authorized Official Telephone | 7085816487 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 247200000X | Technician, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
11104 S KEDZIE AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60655-2330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629632401 | Hillary Woodward Carroll | Nurse Practitioner | 3258 W 111th Chicago, Il, Chicago, IL 60655 | 2019-04-26 |
| 1679029995 | Meghan Robbins | Pharmacy Technician | 10428 S. Springfield, Chicago, IL 60655 | 2016-08-28 |
| 1356700728 | Molly Samansky | Speech-Language Pathologist | 2549 W 106thh Pl, Chicago, IL 60655 | 2016-02-15 |
| 1134533615 | Axis Physical Medicine | Physical Therapist | 11005 S Kedzie Ave, Chicago, IL 60655 | 2014-06-12 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1962772921 | E.m. Branch and Associates, Inc | Social Worker | 3139 W. 111th Street, Chicago, IL 60655 | 2012-01-09 |
| 1922377951 | Patricia Murphy | Counselor | 10435 Kedzie Ave, Chicago, IL 60655 | 2011-12-20 |
| 1346518891 | Kelly Diana Koch | Occupational Therapist | 11143 S. Troy, Chicago, IL 60655 | 2011-12-12 |
| 1265678544 | Lawrence Michael Furlan | Dentist | 10900 S Kedzie, Chicago, IL 60655 | 2008-12-17 |
| 1710122361 | Athletico, Ltd | Physical Therapist | 3644 W. 111th Street, Chicago, IL 60655 | 2008-12-11 |
| Find all providers in zip 60655 | ||||
| Taxonomy Code | 247200000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Other |
| A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |
| Notes: Sources: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988; Dorland’s Illustrated Medical Dictionary, 26th Edition. Philadelphia: W.B. Saunders Company, 1981; and Webster’s II New Riverside University Dictionary. Boston: Riverside Publishing Company, 1984. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205302965 | North Chicago Lice Clinic Inc | Technician, Other | 6308 N Milwaukee Ave, Chicago, IL 60646-3711 | 2018-10-22 |
| 1629594361 | Olivia Cavileer | Technician, Other | 1409 W. Carroll Ave, Chicago, IL 60607 | 2017-08-15 |
| 1225498777 | Kyle Coward | Technician, Other | 6901 S Oglesby Ave Apt 3b, Chicago, IL 60649-1827 | 2016-02-25 |
| 1932566023 | Windycitywheelchairservice | Technician, Other | 6427 S Parnell Ave, Chicago, IL 60621 | 2016-01-21 |
| 1073936100 | Latrece Russell | Technician, Other | 4734 S Prairie Ave, Chicago, IL 60615-1206 | 2014-01-24 |
| 1043655947 | Lori Marlene Ovitz | Technician, Other | 1211 S Prairie Ave Apt 2301, Chicago, IL 60605-3654 | 2013-05-06 |
| 1710240304 | Velma Culverson | Technician, Other | 1514 S Albany Ave, 1514 South Albany Ave, Chicago, IL 60623-2210 | 2012-06-19 |
| 1770654634 | Teresa Kay Thorpe | Technician, Other | 5800 W Higgins Ave, Chicago, IL 60630-2023 | 2006-11-13 |
| 1194178566 | Chicago City Of | Technician, Other | 2133 W Lexington St, Chicago, IL 60612-3707 | 2016-07-20 |
| 1013360429 | Paul Diaz | Technician, Other | 2133 W Lexington St, Chicago, IL 60612-3707 | 2016-07-20 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on DISENTANGLE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.