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General NPI Number Information
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NPI Number | 1699936674
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Entity Type | Organization
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Legal Business Name | K MEDICAL, P.C.
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 4501 W AUGUSTA BLVD
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City | CHICAGO
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State | IL
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Zip | 60651-3302
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Country | US
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Telephone | 773-252-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 7234 W NORTH AVE #1712
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-4239
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Country | US
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Telephone | 773-895-3668
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Fax | 773-764-8650
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Authorized Official
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Title or Position | PRESIDENT
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Name | KAREN HUNT
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Credential | D.P.M.
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Telephone | 773-895-3668
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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 | 016-004758
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License Number State | IL
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