Organization
NORTHERN ILLINOIS HOME MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISSA SHEPPARD-MILLER (PRESIDENT)
(815) 626-4041
Entity
Organization
Contact information
Practice address
3312 RIVER RD, STERLING, IL 61081-4150
(815) 626-4041
(815) 626-6212
Mailing address
3312 RIVER RD, STERLING, IL 61081-4150
(815) 626-4041
(815) 626-6212
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000341
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072724
HEALTH ALLIANCE MED PLANS
—
01
—
09832001
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/16/2005
Last updated
07/05/2016
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