Provider Demographics
NPI:1447818034
Name:LLS DURABLE MEDICAL EQUIPMENT & SUPPLIES
Entity type:Organization
Organization Name:LLS DURABLE MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDE
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ARDIS
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-366-2287
Mailing Address - Street 1:PO BOX 528484
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60652-8484
Mailing Address - Country:US
Mailing Address - Phone:773-366-2287
Mailing Address - Fax:708-897-9807
Practice Address - Street 1:7601 S KOSTNER AVE STE 204
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60652-1126
Practice Address - Country:US
Practice Address - Phone:312-384-1995
Practice Address - Fax:708-897-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies