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	203000412	IL

General Provider Information

NPI Number	:	1548238793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS CHOICE,INC.

Provider Business Mailing Address
First Line	:	600 W CERMAK RD
Second Line	:	LOWER LEVEL
City	:	CHICAGO
State	:	IL
Zip	:	60616-2268
Country	:	US
Telephone Number	:	312-666-1111
Fax Number	:	312-666-1121

Provider Business Practice Location Address
First Line	:	600 W CERMAK RD
Second Line	:	LOWER LEVEL
City	:	CHICAGO
State	:	IL
Zip	:	60616-2268
Country	:	US
Telephone Number	:	312-666-1111
Fax Number	:	312-666-1121

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DANIEL LEON GRAY
Credential	:
Telephone Number	:	312-617-5949

Provider Enumeration Date	:	03/12/2006
Last Update Date	:	01/09/2012

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