| NPI | 1225142813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER G. LICHTY Owner 815-544-9600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203.000100) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2012-09-04 |