| NPI | 1548704299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE ELMER Credentialing Coordinator 815-381-7431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2025-04-11 |