Healthcare Provider Details

I. General information

NPI: 1689008575
Provider Name (Legal Business Name): PDP MEDICAL SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2013
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8647 W 95TH ST
HICKORY HILLS IL
60457-1730
US

IV. Provider business mailing address

376 S SUMMIT AVE COURT E
OAKBROOK TERRACE IL
60181-2987
US

V. Phone/Fax

Practice location:
  • Phone: 630-953-7250
  • Fax:
Mailing address:
  • Phone: 630-953-7250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. JIM KINGSLEY
Title or Position: MANAGER
Credential:
Phone: 630-953-7250