# MEDIMASSAGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194468280
- **Authorized official:** MRS. LILIANA JASMINE SILVA I CMT, PTA (OWNER/ CLINIC DIRECTOR)
- **Authorized official phone:** (708) 759-7903

## Contact information

- **Practice address:** 1910 S. HIGHLAND AVE. UNIT 260, LOMBARD, IL 60148
- **Practice address phone:** (630) 776-3043
- **Practice address fax:** (630) 929-1390
- **Mailing address:** 1910 S. HIGHLAND AVE. UNIT 260, LOMBARD, IL 60148
- **Mailing address phone:** (630) 776-3043
- **Mailing address fax:** (630) 929-1390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0100X | Health Service Clinic/Center | — | NULL | — |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/15/2022
- **Last updated:** 07/29/2023