Organization
DIVERSEY HEALTH CARE CLINIC INC
Active
Other names
Diversey HealthCare Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO MACHADO M.D (PRESIDENT)
(708) 738-7351
Entity
Organization
Contact information
Practice address
4911 W DIVERSEY AVE, CHICAGO, IL 60639-1705
(773) 237-3100
(855) 299-4948
Mailing address
349 BUCKINGHAM CT, LOMBARD, IL 60148-1667
(708) 738-7351
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036.120095
IL
Other
Enumeration date
05/11/2015
Last updated
08/21/2015
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