Healthcare Provider Details

I. General information

NPI: 1912331729
Provider Name (Legal Business Name): SLIP PROOF SAFETY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 FOREST AVE
WILLOW SPRINGS IL
60480-1420
US

IV. Provider business mailing address

320 FOREST AVE
WILLOW SPRINGS IL
60480-1420
US

V. Phone/Fax

Practice location:
  • Phone: 630-935-2861
  • Fax:
Mailing address:
  • Phone: 630-935-2861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WV0202X
TaxonomyVehicle Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name: MR. FRANK MANNELLA
Title or Position: OWNER
Credential:
Phone: 630-935-2860