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General NPI Number Information
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NPI Number | 1740466101
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Entity Type | Organization
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Legal Business Name | DUPAGE PROSTHETIC - ORTHOTIC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 121 E ROOSEVELT RD SUITE B
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City | LOMBARD
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State | IL
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Zip | 60148-4561
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Country | US
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Telephone | 630-261-9317
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Fax | 630-261-9319
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Provider Business Mailing Address
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Address Line | 121 E ROOSEVELT RD SUITE B
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City | LOMBARD
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State | IL
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Zip | 60148-4561
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Country | US
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Telephone | 630-261-9317
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Fax | 630-261-9319
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN E ROONEY
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Credential | C.P. CPED.
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Telephone | 630-261-9317
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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 | IL
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Taxonomy #2
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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 | IL
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Taxonomy #3
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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 | IL
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