Healthcare Provider Details
I. General information
NPI: 1689628273
Provider Name (Legal Business Name): BREEZE TECHNOLOGY & ACCESSORIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/19/2006
Last Update Date: 02/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3029 N BARRINGTON RD
HOFFMAN ESTATES IL
60192-2024
US
IV. Provider business mailing address
660 MCHENRY RD
WHEELING IL
60090-9220
US
V. Phone/Fax
- Phone: 847-765-4008
- Fax: 847-765-4007
- Phone: 847-765-4008
- Fax: 847-765-4007
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 203.000792 |
| License Number State | IL |
VIII. Authorized Official
Name: MISS
WENDI
L
PHILLIPS
Title or Position: PRESIDENT
Credential:
Phone: 316-209-6402