Organization
WILMA, LTD
Active
Other names
PEALRE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JULIE A ANDRIACCHI (MANAGER/ADMIN.)
(708) 343-9009
Entity
Organization
Contact information
Practice address
904 W NORTH AVE, MELROSE PARK, IL 60160-1520
(708) 343-9009
(708) 343-9012
Mailing address
904 W NORTH AVE, MELROSE PARK, IL 60160-1520
(708) 343-9009
(708) 343-9012
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
060.005866046.007691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0494080001
CMS MEDICAL SUPPLIES
IL
Enumeration date
06/07/2007
Last updated
11/15/2007
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