NPI 1033977665

Diverge Health Ipa of Ny LLC

Organisation Case Management Agency Glencoe, IL

Practice location

Address: 500 Adams Ave, Glencoe, IL 60022-1865
Phone: (941) 718-9000

Authorised official

Name: Vincent Pantone
Title: Cmo
Phone: (941) 917-9000

Registered specialties (2)

Case Management Agency Primary

Agencies Taxonomy 251B00000X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Registry record

NPI: 1033977665
Entity type: Organization
NPI issued: 8 Mar 2024
Record last updated: 8 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.