Organization
MIDWEST MEDICAL ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS SMITH (PRESIDENT)
(630) 697-0443
Entity
Organization
Contact information
Practice address
119 NICHOLAS DR, GROVELAND, IL 61535-9564
(630) 697-0443
(888) 455-0899
Mailing address
PO BOX 33, GROVELAND, IL 61535-0033
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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