Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
DUBOIS-DOUGLAS, INC.
Active
Organization
DUBOIS-DOUGLAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FUNMI MARTINS-MENSAH (EXECUTIVE DIRECTOR)
(815) 295-3146
Entity
Organization
Contact information
Practice address
1016 W JACKSON BLVD, CHICAGO, IL 60607-2914
(312) 288-8640
(312) 243-1516
Mailing address
1016 W JACKSON BLVD, CHICAGO, IL 60607-2914
(312) 288-8640
(312) 243-1516
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
12HM519014
IL
253Z00000X
In Home Supportive Care Agency
QMXHPQ0915
IL
302R00000X
Health Maintenance Organization
44CSA00737
IL
305S00000X
Point of Service
QXIPQ0000096439
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0100
—
IL
05
—
0301
—
IL
05
—
0302
—
IL
05
—
0802
—
IL
Enumeration date
07/25/2013
Last updated
10/20/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up