Organization · Type 2 NPI

PMR Illinois Holding, LLC

Non-Pharmacy Dispensing Site · Dolton, IL

NPI number 1013520113 Active

Practice location

600 E Sibley Blvd
Dolton, IL 60419-2599

Call (708) 340-7400 Map

Mailing address

1395 NW 167th St
Miami Gardens, FL 33169-5710

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	None listed

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

4 other providers at this address

NPI record

NPI: 1013520113
Entity type: Organization (Type 2)
Issued: Aug 28, 2020
Last updated: Oct 31, 2024
Status: Active
Subpart: Yes of PMR Illinois Holding, LLC

Other names

<unavail>
Jencare Senior Medical Center Dolton · doing business as
Jencare Senior Medical Center Dolton · doing business as

Authorized official

Mary Chen
Authorized Official
(305) 831-4722

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1013520113

PMR Illinois Holding, LLC's National Provider Identifier is 1013520113, issued on Aug 28, 2020. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Dolton, IL. The record was last updated on Oct 31, 2024.