| NPI | 1073805552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VITALI CHAIAN Member 773-366-2159 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 2092906) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |