| NPI | 1295894319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WILFORD Owner 773-744-1578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203.000143) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IN 69000193A) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2013-02-26 |