| NPI | 1669870945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK ROLISON Owner/Manager 312-291-9066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: IL 2943) |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |