Individual
BRIAN COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4916 N CRESCENT AVE, NORRIDGE, IL 60706-3108
(708) 420-0063
Mailing address
4916 N CRESCENT AVE, NORRIDGE, IL 60706-3108
(708) 420-0063
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/05/2013
Last updated
11/05/2013
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