Healthcare Provider Details

I. General information

NPI: 1942266473
Provider Name (Legal Business Name): ADVANCE MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 09/14/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 S FAIRFIELD AVE
CHICAGO IL
60608-2410
US

IV. Provider business mailing address

1930 S FAIRFIELD AVE
CHICAGO IL
60608-2410
US

V. Phone/Fax

Practice location:
  • Phone: 163-083-4150
  • Fax: 163-083-4228
Mailing address:
  • Phone: 163-083-4150
  • Fax: 163-083-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203000201
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number203000201
License Number StateIL

VIII. Authorized Official

Name: ANDREW REINHARDT
Title or Position: PRESIDENT
Credential:
Phone: 630-834-1508