Organization
MIDWEST HAND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE SOUTHWORTH OTR/L CHT (OWNER)
(815) 729-2999
Entity
Organization
Contact information
Practice address
823 129TH INFANTRY DR, SUITE104, JOLIET, IL 60435-8346
(815) 729-2999
(815) 729-1950
Mailing address
823 129TH INFANTRY DR, SUITE104, JOLIET, IL 60435-8346
(815) 729-2999
(815) 729-1950
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
225XOOOOOX
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1281410001
MEDICARE DME
IL
01
—
1821128620
MEDICARE NPI
IL
Enumeration date
01/14/2009
Last updated
01/14/2009
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