1295164531 NPI number — HEALTHCARE PLUS SOLUTIONS INC.

Table of content: MARY JO GROVES M.D. (NPI 1730124371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295164531 NPI number — HEALTHCARE PLUS SOLUTIONS INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHCARE PLUS SOLUTIONS INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295164531
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5017 S DREXEL BLVD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60615-2791
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-262-8867
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5017 S DREXEL BLVD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60615-2791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-262-8867
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/07/2013

Additional Information

Authorized Official

Authorized Official Last Name:
GLENN
Authorized Official First Name:
DIANNE
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
312-262-8867

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  041197425 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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