| |
1611 W Harrison St Ste 510, Chicago, IL 60612-4861 | |
(847) 390-7666 | |
(847) 390-9345 |
Full Name | |
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Type | Facility |
Speciality | Durable Medical Equipment & Medical Supplies |
Location | 1611 W Harrison St Ste 510, Chicago, Illinois |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1407586159 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213ES0103X | Podiatrist - Foot & Ankle Surgery | (* (Not Available)) | Secondary |
332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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1660 Feehanville Dr Ste 450, Mt Prospect, IL 60056-6023 Ph: (847) 390-7666 | 1611 W Harrison St Ste 510, Chicago, IL 60612-4861 Ph: (847) 390-7666 |