DIVERSEY HEALTH CARE CLINIC INC (NPI# 1225416308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225416308 |
| Entity Type | Organization |
| Organization Name | DIVERSEY HEALTH CARE CLINIC INC |
| Other Organization Name | DIVERSEY HEALTHCARE CLINIC |
| Practice Address |
4911 W Diversey Ave Chicago IL 60639-1705 |
| Mailing Address |
349 Buckingham Ct Lombard IL 60148-1667 |
| Practice Telephone | 7732373100 |
| Practice Fax Number | 8552994948 |
| Mailing Telephone | 7087387351 |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-08-21 |
| Authorized Official Name | DR. RICARDO MACHADO (PRESIDENT) |
| Authorized Official Telephone | 7087387351 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
036.120095 | IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Diversey HealthCare Clinic | Doing Business As Name - Organization |
| Street Address |
4911 W DIVERSEY AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60639-1705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780893990 | Isza Aich-ranjbari | Dentist | 4911 W Diversey Ave, Chicago, IL 60639-1705 | 2007-05-22 |
| 1346615820 | Absolute Dentistry Ltd | Dentist | 4911 W Diversey Ave, Chicago, IL 60639-1705 | 2015-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293801 | Wh Il Dental Pllc | Dentist | 18086 N. Kilpatrick Ave., Chicago, IL 60639 | 2020-10-21 |
| 1568012375 | Ellen E Cox | Physical Therapist | 4369 W Diversey Ave, Chicago, IL 60639 | 2019-09-13 |
| 1306379268 | Michael Duarte | Family Medicine | 4417 W Diversey Ave, Chicago, IL 60639 | 2017-04-07 |
| 1013464593 | Ismile Dental | Dentist | 4953 West Fullerton Ave, Chicago, IL 60639 | 2016-09-01 |
| 1952773566 | Flor Cortes | Pharmacist | 4626 W Diversey, Chicago, IL 60639 | 2015-10-22 |
| 1205178654 | The Head Injury Center for Prevention and Community | Case Management | 1732 N. Narragansett Ave, Chicago, IL 60639 | 2013-03-25 |
| 1013299262 | Aamer Arboleda | Pharmacist | 1606 N. Mobile Ave., Chicago, IL 60639 | 2011-09-14 |
| 1295037927 | Mary Veronica Galiotto | Pharmacist | 2920 N Narragansett, Chicago, IL 60639 | 2010-12-01 |
| 1295067478 | Galileo Optical Co. | Eyewear Supplier (Equipment, not the service) | 5759 W. Fullerton, Chicago, IL 60639 | 2010-02-12 |
| 1831424548 | Sonrisa Family Dental At The Hall, P.C. | Dentist | 4608 A & B West Diversey Avenue, Chicago, IL 60639 | 2009-10-14 |
| Find all providers in zip 60639 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538792221 | Greenbax Health Solutions, LLC | Clinic/Center | 4922 W Chicago Ave, Chicago, IL 60651-3142 | 2020-02-20 |
| 1033760780 | Careatc | Clinic/Center | 600 S Michigan Ave # 402, Chicago, IL 60605-1900 | 2019-09-24 |
| 1356814503 | Thompson Medical Incorporated | Clinic/Center | 933 E Hyde Park Blvd Ste G, Chicago, IL 60615-2722 | 2019-01-09 |
| 1497251037 | Thomas L Pitts, Md LLC | Clinic/Center | 233 E Erie St Ste 702, Chicago, IL 60611-5933 | 2018-04-03 |
| 1407209208 | Mount Sinai Hospital Medical Center | Clinic/Center | 1501 S California Ave # L1026, Chicago, IL 60608-1732 | 2016-07-16 |
| 1487058731 | Encinas Medical Center | Clinic/Center | 4614 S Ashland Ave, Chicago, IL 60609-3251 | 2014-10-15 |
| 1366872061 | Lawndale Christian Health Center | Clinic/Center | 5122 S Archer Ave, Chicago, IL 60632-4508 | 2013-11-15 |
| 1083051643 | Oak Street Health Physicians Group, PC | Clinic/Center | 30 W Monroe St Ste 1200, Chicago, IL 60603-2420 | 2013-05-22 |
| 1043564529 | Triple S Medical Care S.c. | Clinic/Center | 6455 S Pulaski Rd, Chicago, IL 60629 | 2012-11-05 |
| 1548541022 | Valentinalb,s.c. | Clinic/Center | 5108 N Lincoln Ave, Chicago, IL 60625-7295 | 2011-08-29 |
| Find all providers in CHICAGO | ||||
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| 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.