Healthcare Provider Details

I. General information

NPI: 1225097876
Provider Name (Legal Business Name): CENTRAL IL MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 E LOCUST ST STE 2
BLOOMINGTON IL
61701-8432
US

IV. Provider business mailing address

203 E LOCUST ST STE 2
BLOOMINGTON IL
61701-8432
US

V. Phone/Fax

Practice location:
  • Phone: 309-827-3459
  • Fax: 309-827-4638
Mailing address:
  • Phone: 309-827-3459
  • Fax: 309-827-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203000065
License Number StateIL

VIII. Authorized Official

Name: WILLIAM M MARTIN
Title or Position: OWNER
Credential:
Phone: 309-828-2242