Provider Demographics
NPI:1962867929
Name:LOCAL HEALTH, INC
Entity type:Organization
Organization Name:LOCAL HEALTH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZELIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:815-715-8502
Mailing Address - Street 1:134 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:61361-9357
Mailing Address - Country:US
Mailing Address - Phone:815-454-8054
Mailing Address - Fax:815-454-8000
Practice Address - Street 1:134 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:IL
Practice Address - Zip Code:61361-9357
Practice Address - Country:US
Practice Address - Phone:815-454-8054
Practice Address - Fax:815-454-8000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-17
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
IL054-0198403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2156107OtherPK