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General NPI Number Information
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NPI Number | 1396661831
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Entity Type | Organization
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Legal Business Name | I G MEDICAL INC
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 2425 W 22ND ST STE 101
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City | OAK BROOK
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State | IL
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Zip | 60523-4642
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Country | US
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Telephone | 630-990-2212
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Fax |
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Provider Business Mailing Address
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Address Line | 11685 GOLDEN GATE DR
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City | MOKENA
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State | IL
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Zip | 60448-2032
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-PRINCIPAL
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Name | KENNETH PORTILLO
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Credential |
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Telephone | 708-334-8125
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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 |
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License Number State |
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