MEDICARE: DOCTORS CHOICE 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

General Provider Information

NPI Number	:	1295965093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS CHOICE INC

Provider Business Mailing Address
First Line	:	1345 S MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605
Country	:	US
Telephone Number	:	312-322-9990
Fax Number	:	312-322-9994

Provider Business Practice Location Address
First Line	:	1345 S MICHIGAN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605
Country	:	US
Telephone Number	:	312-322-9990
Fax Number	:	312-322-9994

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	MR. DANIEL GRAY
Credential	:
Telephone Number	:	312-617-5949

Provider Enumeration Date	:	07/15/2009
Last Update Date	:	07/15/2009

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