| NPI | 1639014871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM HERRY Manager 773-289-0934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 332BD1200X Durable Medical Equipment & Medical Supplies, Dialysis Equipment & Supplies | |
| Enumeration Date | 2026-04-22 |
| Last Update Date | 2026-05-28 |