MEDICARE: RPAV MANAGEMENT DME 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	:	1750192969
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RPAV MANAGEMENT DME INC

Provider Business Mailing Address
First Line	:	PO BOX 593
Second Line	:
City	:	WAUCONDA
State	:	IL
Zip	:	60084-0593
Country	:	US
Telephone Number	:	773-317-4888
Fax Number	:

Provider Business Practice Location Address
First Line	:	4149 W 26TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-4314
Country	:	US
Telephone Number	:	773-317-4888
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MANISH PANDYA
Credential	:	DC
Telephone Number	:	773-317-4888

Provider Enumeration Date	:	01/16/2025
Last Update Date	:	01/16/2025

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