MEDICARE: AMERICAN DME SUPPLY, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies		IL

General Provider Information

NPI Number	:	1568657708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN DME SUPPLY, INC

Provider Business Mailing Address
First Line	:	1314 W NORTHWEST HWY
Second Line	:	SUITE 107
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5261
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 W NORTHWEST HWY
Second Line	:	SUITE 107
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5261
Country	:	US
Telephone Number	:	847-577-8301
Fax Number	:	847-577-8302

Authorized Official
Title or Position	:	OWNER
Name	:	MISS MARIANNA PROZUMENT
Credential	:
Telephone Number	:	847-577-8301

Provider Enumeration Date	:	09/11/2007
Last Update Date	:	04/20/2008

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