Organization
ST AGNES MEDICAL EQUIPMENT CO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J O'BRIEN SR. (VICE PRESIDENT)
(312) 787-9400
Entity
Organization
Contact information
Practice address
2540 S WABASH AVE, CHICAGO, IL 60616-2309
(312) 674-9494
(312) 674-9595
Mailing address
1541 N WELLS ST, CHICAGO, IL 60610-1307
(312) 787-9400
(312) 787-9434
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
IL
Other
Enumeration date
04/17/2007
Last updated
08/22/2020
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