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General NPI Number Information
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NPI Number | 1609676501
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Entity Type | Organization
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Legal Business Name | MEDTECH DEVICES LLC
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1711 NORMAN BLVD
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City | PARK RIDGE
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State | IL
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Zip | 60068-3850
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Country | US
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Telephone | 708-949-1044
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 616
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City | PARK RIDGE
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State | IL
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Zip | 60068-0616
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Country | US
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Telephone | 708-949-1044
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ANSU DURGUT
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Credential | DC
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Telephone | 708-949-1044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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