MEDICARE: ROTTAM LLC

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	:	1881301430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROTTAM LLC

Provider Business Mailing Address
First Line	:	18315 PEACHTREE DR
Second Line	:
City	:	TINLEY PARK
State	:	IL
Zip	:	60487-8652
Country	:	US
Telephone Number	:	708-506-8292
Fax Number	:

Provider Business Practice Location Address
First Line	:	7244 W BENTON DR
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-9303
Country	:	US
Telephone Number	:	708-506-8292
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ROLAND OKWEN
Credential	:
Telephone Number	:	708-506-8292

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	03/20/2024

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Directions to “ROTTAM LLC ” Practice Location

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