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General NPI Number Information
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NPI Number | 1770738007
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Entity Type | Organization
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Legal Business Name | D V JAHN INC
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Dates
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Enumeration Date | 12/01/2008
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Last Update Date | 05/25/2010
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Provider Practice Location Address
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Address Line | 25661 NORTH HILLVIEW CT
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City | MUNDELEIN
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State | IL
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Zip | 60060-9426
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Country | US
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Telephone | 847-550-1898
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Fax |
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Provider Business Mailing Address
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Address Line | 25661 NORTH HILLVIEW CT
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City | MUNDELEIN
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State | IL
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Zip | 60060-9426
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Country | US
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Telephone | 847-550-1898
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. DMITRIY VICTOR JAHN
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Credential |
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Telephone | 847-452-2975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 203001045
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License Number State | IL
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