Provider Demographics
NPI:1992126957
Name:CML HEALTH INC
Entity type:Organization
Organization Name:CML HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-677-9657
Mailing Address - Street 1:404 N GALENA AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-2115
Mailing Address - Country:US
Mailing Address - Phone:815-677-9657
Mailing Address - Fax:815-677-9658
Practice Address - Street 1:404 N GALENA AVE
Practice Address - Street 2:STE 110
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-2115
Practice Address - Country:US
Practice Address - Phone:815-677-9657
Practice Address - Fax:815-677-9658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3000965253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care