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General NPI Number Information
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NPI Number | 1760940100
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Entity Type | Organization
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Legal Business Name | EQMD, INC.
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Dates
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Enumeration Date | 03/05/2019
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Last Update Date | 03/05/2019
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Provider Practice Location Address
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Address Line | 1800 NATIONS DR STE 216
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City | GURNEE
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State | IL
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Zip | 60031-9174
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Country | US
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Telephone | 847-672-6515
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7929
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City | GURNEE
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State | IL
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Zip | 60031-7007
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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 | PRESIDENT
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Name | MR. GREGORY MAY
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Credential |
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Telephone | 847-672-6515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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