MEDICARE: PHC RESPIRATORY SERVICES, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1336337302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHC RESPIRATORY SERVICES, LLC.

Provider Business Mailing Address
First Line	:	7444 LONG AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-3214
Country	:	US
Telephone Number	:	847-329-4100
Fax Number	:	847-329-4900

Provider Business Practice Location Address
First Line	:	7444 LONG AVE
Second Line	:
City	:	SKOKIE
State	:	IL
Zip	:	60077-3214
Country	:	US
Telephone Number	:	847-329-4100
Fax Number	:	847-329-4900

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. BEN KLEIN
Credential	:
Telephone Number	:	847-329-4100

Provider Enumeration Date	:	10/04/2007
Last Update Date	:	10/04/2007

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