Organization
LIVING WELL HEALTH MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDA M DIXON (PRESIDENT)
(773) 285-9100
Entity
Organization
Contact information
Practice address
4150 S BERKELEY AVE, CHICAGO, IL 60653-3010
(773) 285-9100
(773) 451-2770
Mailing address
4150 S BERKELEY AVE, CHICAGO, IL 60653-3010
(773) 285-9100
(773) 451-2770
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
209009287
IL
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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