Healthcare Provider Details

I. General information

NPI: 1114063229
Provider Name (Legal Business Name): DELNOR HOME MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 05/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

964 N 5TH AVE BUILDING C
SAINT CHARLES IL
60174-1204
US

IV. Provider business mailing address

964 N 5TH AVE BUILDING C
SAINT CHARLES IL
60174-1204
US

V. Phone/Fax

Practice location:
  • Phone: 630-513-0370
  • Fax: 630-513-8462
Mailing address:
  • Phone: 630-513-0370
  • Fax: 630-513-8462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203.000639
License Number StateIL

VIII. Authorized Official

Name: MS. KATHLEEN TEDESCO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 630-513-0370