| NPI | 1760411300 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORGE ALBERTO BOLANO President 847-982-9880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: IL 203-000309) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2009-07-28 |