MEDICARE: ADVANCE MEDICAL EQUIPMENT, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	203000201	IL
2	332B00000X	Durable Medical Equipment & Medical Supplies	203000201	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0002221379	OTHER	IL	DME

General Provider Information

NPI Number	:	1942266473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCE MEDICAL EQUIPMENT, INC

Provider Business Mailing Address
First Line	:	1930 S FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2410
Country	:	US
Telephone Number	:	163-083-4150
Fax Number	:	163-083-4228

Provider Business Practice Location Address
First Line	:	1930 S FAIRFIELD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-2410
Country	:	US
Telephone Number	:	163-083-4150
Fax Number	:	163-083-4228

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW REINHARDT
Credential	:
Telephone Number	:	630-834-1508

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	09/14/2020

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