Organization
SPECIALTY WHEELCHAIR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR N ODARCZENKO (PRESIDENT/CEO)
(847) 202-4660
Entity
Organization
Contact information
Practice address
742 E NORTHWEST HWY, PALATINE, IL 60074-6353
(847) 202-4660
(847) 202-4681
Mailing address
742 E. NORTHWEST HWY., PALATINE, IL 60074
(847) 202-4660
(847) 202-4681
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202885030001
PUBLICAID
IL
Enumeration date
08/10/2007
Last updated
08/10/2007
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