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General NPI Number Information
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NPI Number | 1790782480
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Entity Type | Organization
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Legal Business Name | HOME AIR OF JOLIET,LTD.
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 09/06/2017
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Provider Practice Location Address
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Address Line | 1500 ESSINGTON RD SUITE 3
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City | JOLIET
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State | IL
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Zip | 60435-8414
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Country | US
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Telephone | 815-741-0712
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Fax | 815-741-9277
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Provider Business Mailing Address
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Address Line | 1500 ESSINGTON RD SUITE 3
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City | JOLIET
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State | IL
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Zip | 60435-8414
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Country | US
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Telephone | 815-741-0712
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Fax | 815-741-9277
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DENISE EDMAN
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Credential |
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Telephone | 815-741-0712
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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 | 203000549
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License Number State | IL
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