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General NPI Number Information
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NPI Number | 1770576902
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Entity Type | Organization
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Legal Business Name | BIOCONCEPTS INC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 100 TOWER DR SUITE 101
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City | BURR RIDGE
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State | IL
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Zip | 60527-5777
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Country | US
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Telephone | 630-986-0007
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Fax | 630-986-0151
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Provider Business Mailing Address
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Address Line | 100 TOWER DR SUITE 101
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City | BURR RIDGE
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State | IL
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Zip | 60527-5777
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Country | US
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Telephone | 630-986-0007
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Fax | 630-986-0151
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. THOMAS M GAVIN
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Credential |
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Telephone | 630-986-0007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 213000021
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License Number State | IL
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