MEDICARE: DALEY'S MEDICAL AND RENTAL SUPPLY

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	203000559	IL
2	332BX2000X	Oxygen Equipment & Supplies (DME)	203000559	IL

General Provider Information

NPI Number	:	1306866231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALEY'S MEDICAL AND RENTAL SUPPLY

Provider Business Mailing Address
First Line	:	PO BOX 659
Second Line	:
City	:	DOLTON
State	:	IL
Zip	:	60419-0659
Country	:	US
Telephone Number	:	708-841-8090
Fax Number	:	708-849-0997

Provider Business Practice Location Address
First Line	:	1234 E SIBLEY BLVD
Second Line	:
City	:	DOLTON
State	:	IL
Zip	:	60419-2944
Country	:	US
Telephone Number	:	708-841-8090
Fax Number	:	708-849-0997

Authorized Official
Title or Position	:	OWNER
Name	:	MR. THOMAS WAPPEL
Credential	:
Telephone Number	:	708-841-8090

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/23/2008

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Directions to “DALEY'S MEDICAL AND RENTAL SUPPLY ” Practice Location

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