Organization
DETA CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERMELINDA P. DJONDO COLLEGE GRADUATE (VICE-PRESIDENT)
(708) 756-7440
Entity
Organization
Contact information
Practice address
3259 HOLEMAN AVE, SOUTH CHICAGO HEIGHTS, IL 60411-5515
(708) 756-7440
(708) 756-7680
Mailing address
3259 HOLEMAN AVE, SOUTH CHICAGO HEIGHTS, IL 60411-5515
(708) 756-7440
(708) 756-7680
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Enumeration date
05/28/2006
Last updated
08/22/2020
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