Distinctively Me | |
33 W 155th Pl South Holland IL 60473-1202 | |
(708) 730-2340 | |
Not Available |
Full Name | Distinctively Me |
---|---|
Speciality | Community/behavioral Health |
Location | 33 W 155th Pl, South Holland, Illinois |
Authorized Official Name and Position | Gloria Dotson-lewis (FOUNDER/EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7735041571 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Distinctively Me 33 W 155th Pl South Holland IL 60473-1202 Ph: () - | Distinctively Me 33 W 155th Pl South Holland IL 60473-1202 Ph: (708) 730-2340 |
NPI Number | 1174230585 |
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Provider Enumeration Date | 11/04/2022 |
Last Update Date | 11/04/2022 |
Certification Date | 11/04/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174230585 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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