Healthcare Provider Details

I. General information

NPI: 1306750112
Provider Name (Legal Business Name): EXPRESS DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E MAIN ST
BRAIDWOOD IL
60408-1957
US

IV. Provider business mailing address

115 E MAIN ST
BRAIDWOOD IL
60408-1957
US

V. Phone/Fax

Practice location:
  • Phone: 888-446-4118
  • Fax:
Mailing address:
  • Phone: 888-446-4118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOHN KENEDDY
Title or Position: OWNER
Credential:
Phone: 888-940-1120