| NPI | 1467418350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY C ROSS Administrative Assistant 309-676-5546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 042000244) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2009-12-07 |