Organization
4D HEALTHWARE, LLC
Active
Parent organization
4D HEALTHWARE, LLC
Other names
4D HEALTHWARE LLC CLINICAL CONSORTIUM
Organization subpart
Yes
Provider details
NPI number
Legal business name
4D HEALTHWARE, LLC
Authorized official
STAR CUNNINGHAM (FOUNDER/CEO)
(847) 650-7827
Entity
Organization
Contact information
Practice address
401 N MICHIGAN AVE STE 1740, CHICAGO, IL 60611-4742
(224) 633-9472
(630) 857-9069
Mailing address
401 N MICHIGAN AVE STE 1740, CHICAGO, IL 60611-4742
(224) 633-9472
(630) 857-9069
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
036-094623
IL
171M00000X
Case Manager/Care Coordinator
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPTIONAL
OPTIONAL OPT OUT
IL
Enumeration date
07/20/2018
Last updated
06/11/2019
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