| NPI | 1487720140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MERIDETH Manager 309-517-6710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203001033) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2015-07-10 |