Healthcare Provider Details

I. General information

NPI: 1215612866
Provider Name (Legal Business Name): CPO SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2023
Last Update Date: 06/21/2023
Certification Date: 06/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 N RANDALL RD STE 170
ELGIN IL
60123-9403
US

IV. Provider business mailing address

741 W MAIN ST
PEORIA IL
61606-1953
US

V. Phone/Fax

Practice location:
  • Phone: 847-201-2159
  • Fax: 847-213-9394
Mailing address:
  • Phone: 309-285-7752
  • Fax: 309-285-7752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: AMIT V BHANTI
Title or Position: CEO
Credential: LO
Phone: 309-676-2276