Healthcare Provider Details
I. General information
NPI: 1750498366
Provider Name (Legal Business Name): BIOCONCEPTS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/23/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 FAIRLANE DR
JOLIET IL
60435-5484
US
IV. Provider business mailing address
100 TOWER DR
BURR RIDGE IL
60527-5777
US
V. Phone/Fax
- Phone: 815-725-7901
- Fax: 815-725-7560
- Phone: 630-986-0007
- Fax: 630-986-0151
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: MR.
THOMAS
GAVIN
Title or Position: PRESIDENT
Credential:
Phone: 630-986-0007