| NPI | 1962695924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIETA R MITRA President/Secretary/Treasurer 708-615-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203.000910) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2017-03-09 |