MEDICARE: ANDSAR INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	2003000761	IL

General Provider Information

NPI Number	:	1124292149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDSAR INC.

Provider Business Mailing Address
First Line	:	5023 FAIRVIEW AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3986
Country	:	US
Telephone Number	:	630-512-0202
Fax Number	:

Provider Business Practice Location Address
First Line	:	5023 FAIRVIEW AVE
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-3986
Country	:	US
Telephone Number	:	630-512-0202
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. WILLIAM G FUNK
Credential	:
Telephone Number	:	630-584-0310

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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