Healthcare Provider Details

I. General information

NPI: 1205082757
Provider Name (Legal Business Name): MIDWEST DRESSING SUPPLY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2008
Last Update Date: 08/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 N HIGHLAND AVE STE 7
AURORA IL
60506-1470
US

IV. Provider business mailing address

1300 N HIGHLAND AVE STE 7
AURORA IL
60506-1470
US

V. Phone/Fax

Practice location:
  • Phone: 630-896-5600
  • Fax: 630-896-5655
Mailing address:
  • Phone: 630-896-5600
  • Fax: 630-896-5655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN W LAMIOT
Title or Position: PRESIDENT
Credential: DMP
Phone: 630-896-5600