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General NPI Number Information
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NPI Number | 1104033042
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Entity Type | Organization
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Legal Business Name | INTEGRA HEALTHCARE EQUIPMENT LLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 321 W LAKE ST STE C
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City | ELMHURST
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State | IL
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Zip | 60126-1539
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Country | US
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Telephone | 630-516-8320
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Fax | 630-834-1500
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Provider Business Mailing Address
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Address Line | 321 W LAKE ST STE C
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City | ELMHURST
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State | IL
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Zip | 60126-1539
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Country | US
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Telephone | 630-516-8371
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Fax | 630-834-1500
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EITAN SCHECHTER
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Credential |
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Telephone | 630-516-8320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 203000898
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License Number State | IL
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