Healthcare Provider Details

I. General information

NPI: 1881970655
Provider Name (Legal Business Name): UNITED SEATING AND MOBILITY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 THUNDERBIRD LN SUITE 1
EAST PEORIA IL
61611-5536
US

IV. Provider business mailing address

805 BROOK ST STE 402
ROCKY HILL CT
06067-3450
US

V. Phone/Fax

Practice location:
  • Phone: 309-699-0509
  • Fax: 309-698-3361
Mailing address:
  • Phone: 314-447-7500
  • Fax: 314-447-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0255-1845
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number0255-1845
License Number StateIL

VIII. Authorized Official

Name: SONIA LEE VILLESCAS
Title or Position: SR MGR LICENSING & CREDENTIALING
Credential:
Phone: 314-447-7515