Healthcare Provider Details

I. General information

NPI: 1316311897
Provider Name (Legal Business Name): A TO Z MOBILITY AND MEDICAL EQUIPMENT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 04/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23838 W INDUSTRIAL DR N SUITE 200
PLAINFIELD IL
60585-8516
US

IV. Provider business mailing address

23838 W INDUSTRIAL DR N SUITE 200
PLAINFIELD IL
60585-8516
US

V. Phone/Fax

Practice location:
  • Phone: 779-234-9072
  • Fax: 779-234-9063
Mailing address:
  • Phone: 779-234-9072
  • Fax: 779-234-9063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number203.001831
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. PETER G SANTUCCI
Title or Position: PRESIDENT
Credential:
Phone: 779-234-9072