| NPI | 1699779322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE POE Owner/ Manager 217-422-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203000231) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2009-04-23 |