Ellen M Hennecke Dosc

LBN: Ellen M Hennecke Dosc
Ellen M Hennecke Dosc is an health care organization with primary practice located at 3927 W 95Th St , Evergreen Park IL 60805-1903. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Ellen M Hennecke Dosc can be contacted via phone (708) 799-8440, or through Wylie, Kim via phone (708) 799-8440.

Contact Information

Primary practice address
3927 W 95Th St Evergreen Park IL 60805-1903
Phone: (708) 799-8440
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Wylie, Kim
Phone: (708) 799-8440

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1780885657
LBN Legal business name Ellen M Hennecke Dosc
DBA Doing business as
Authorized official Wylie, Kim
Entity Organization
Organization subpart 1 No
Enumeration date May 30th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780885657 NPPES
Illinois Other 01628066 BLUE SHIELD

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