Healthcare Provider Details

I. General information

NPI: 1396661831
Provider Name (Legal Business Name): I G MEDICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 W 22ND ST STE 101
OAK BROOK IL
60523-4642
US

IV. Provider business mailing address

11685 GOLDEN GATE DR
MOKENA IL
60448-2032
US

V. Phone/Fax

Practice location:
  • Phone: 630-990-2212
  • Fax:
Mailing address:
  • Phone:
  • 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: KENNETH PORTILLO
Title or Position: CO-PRINCIPAL
Credential:
Phone: 708-334-8125