Organization
CENTRAD HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM R KORSLIN (PRESIDENT, CEO)
(630) 369-5840
Entity
Organization
Contact information
Practice address
184 SHUMAN BLVD, STE 130, NAPERVILLE, IL 60563-8474
(630) 369-5840
(630) 369-5436
Mailing address
184 SHUMAN BLVD, STE 130, NAPERVILLE, IL 60563-8474
(630) 369-5840
(630) 369-5436
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203-000502
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107879
—
CT
05
—
00440846
—
MS
05
—
00876191A
—
GA
05
—
009974810
—
AL
05
—
02163179
—
NY
01
—
02230052
BLUE CROSS BLUE SHIELD
IL
05
—
0530980
—
IA
05
—
1431532
—
LA
05
—
18130372
—
CO
05
—
200287520A
—
IN
05
—
221343500
—
MN
05
—
520115
—
AR
05
—
52482
—
ND
05
—
75 871044 01
—
KS
05
—
8251002 00
—
MD
05
—
8705402
—
NJ
05
—
MS284IL
—
AK
Enumeration date
05/27/2005
Last updated
12/06/2011
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