| NPI | 1700198991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIWANDA DAVENPORT Co Owner 773-629-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 2042849) |
| Enumeration Date | 2010-07-05 |
| Last Update Date | 2010-07-05 |