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General NPI Number Information
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NPI Number | 1255567558
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Entity Type | Organization
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Legal Business Name | LAWRENCE T. KACMAR MDSC
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Dates
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Enumeration Date | 06/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 3965 75TH ST SUITE 103
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City | AURORA
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State | IL
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Zip | 60504-7925
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Country | US
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Telephone | 630-375-1625
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Fax | 630-375-1925
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Provider Business Mailing Address
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Address Line | 3965 75TH ST SUITE 103
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City | AURORA
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State | IL
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Zip | 60504-7925
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Country | US
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Telephone | 630-375-1625
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Fax | 630-375-1925
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MARGARET M COOLEY
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Credential |
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Telephone | 630-375-1625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 036091557
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License Number State | IL
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