| NPI | 1457508830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D DAVID PESAVENTO Owner 815-725-8425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 046007408) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2010-08-10 |