Organization
A PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NELSON A DAGIO (OWNER)
(312) 217-0295
Entity
Organization
Contact information
Practice address
799 ROOSEVELT RD, BUILDING 3, ROOM 104C, GLEN ELLYN, IL 60137-5908
(630) 545-0433
(630) 545-0433
Mailing address
799 ROOSEVELT RD, BUILDING 3, ROOM 104C, GLEN ELLYN, IL 60137-5908
(630) 545-0433
(630) 545-0433
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1771033
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5595070001
NATIONAL GOVERNMENT SERVICES
IL
Enumeration date
05/01/2008
Last updated
10/10/2008
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