LIVING WELL HEALTH MANAGEMENT INC
Managed Care Organizations at Berkeley Ave, Chicago, IL

License number
Illinois 209009287
Category
Managed Care Organizations
Type
Exclusive Provider Organization
Owner
Name: IDA M DIXON
Title: PRESIDENT
Phone: (773) 285-9100
Address
Address
4150 S Berkeley Ave, Chicago, IL 60653
National Provider ID: 1336408517
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LIVING WELL HEALTH MANAGEMENT INC

Chicago, IL 60653

Status:
Inactive
Registration:
Jan 24, 2012
State ID:
68262739
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Ida M Dixon,4150 Berkeley Ave, Chicago, IL 60653 (Physical)

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