Organization
INNOVATIVE MEDICAL CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES D JUDGE (ONER)
(708) 478-1706
Entity
Organization
Contact information
Practice address
19070 EVERETT BLVD UNIT 204, MOKENA, IL 60448-2073
(708) 390-3362
Mailing address
19070 EVERETT BLVD UNIT 204, MOKENA, IL 60448-2073
(708) 390-3362
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70873903362
NPI
IL
01
—
9999999
PRIVATE
IL
Enumeration date
07/06/2021
Last updated
11/20/2021
Update your record
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