Healthcare Provider Details

I. General information

NPI: 1477684132
Provider Name (Legal Business Name): AXIOS MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 W FULTON ST STE 509
CHICAGO IL
60612-2345
US

IV. Provider business mailing address

2003 W FULTON ST STE 509
CHICAGO IL
60612-2345
US

V. Phone/Fax

Practice location:
  • Phone: 312-738-2330
  • Fax: 312-738-2395
Mailing address:
  • Phone: 312-738-2330
  • Fax: 312-738-2395

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203000367
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: ARISTOTLE KORNAROS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 312-738-2330