MEDICARE: HOME ACCESS PROFESSIONALS, 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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1922467935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOME ACCESS PROFESSIONALS, LLC

Provider Business Mailing Address
First Line	:	210 W CAMPUS DR STE B
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-7829
Country	:	US
Telephone Number	:	847-403-0120
Fax Number	:	847-590-1728

Provider Business Practice Location Address
First Line	:	210 W CAMPUS DR STE B
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-7829
Country	:	US
Telephone Number	:	847-403-0120
Fax Number	:	847-590-1728

Authorized Official
Title or Position	:	SECRETARY / TREASURER
Name	:	ELIZABETH SHAW CRANDALL
Credential	:
Telephone Number	:	847-403-0120

Provider Enumeration Date	:	02/18/2016
Last Update Date	:	02/18/2016

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