Healthcare Provider Details

I. General information

NPI: 1306141916
Provider Name (Legal Business Name): ACCESS ELEVATOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2011
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 CONGRESS CIRCLE W
ROSELLE IL
60172
US

IV. Provider business mailing address

42 CONGRESS CIRCLE W
ROSELLE IL
60172
US

V. Phone/Fax

Practice location:
  • Phone: 630-616-6249
  • Fax: 630-595-6249
Mailing address:
  • Phone: 630-616-6249
  • Fax: 630-595-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: JON TEVZ
Title or Position: OWNER
Credential:
Phone: 414-758-2900