| NPI | 1528239605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR ALEXANDER BARRIOS Owner 312-479-0403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IL 212000132) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: IL 212000132) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IL 212000132) | |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies (Licence: IL 212000132) | |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2012-05-10 |