Andre T Dejean /Dejean Wellness

LBN: Andre T Dejean /Dejean Wellness
Andre T Dejean /Dejean Wellness is an health care organization with primary practice located at 9040 S Merrill Ave , Chicago IL 60617-3811. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Andre T Dejean /Dejean Wellness can be contacted via phone (773) 620-9864, or through Dejean, Andre T via phone (773) 620-9864.

Contact Information

Primary practice address
9040 S Merrill Ave Chicago IL 60617-3811
Phone: (773) 620-9864
Fax: (866) 261-3402
Website:
Map and Directions
Authorized official contact:
Name: Dejean, Andre T Doctor of Medicine (MD)
Phone: (773) 620-9864

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036098449 Illinois

Profile Details

NPI number 1952532426
LBN Legal business name Andre T Dejean /Dejean Wellness
DBA Doing business as
Authorized official Dejean, Andre T Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 2nd, 2009
Last updated Aug 2nd, 2009 - about 17 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 1952532426 NPPES
Illinois Other 1639140700 NPI
Illinois MEDICAID 036098449 NPI

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