| NPI | 1518284587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD ALAN HORACK Owner 309-635-6096 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 39874656) |
| Enumeration Date | 2010-04-29 |
| Last Update Date | 2015-10-13 |