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Organization

DAMON LAKE MEDIA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSHUA LUSTIG (OWNER)
(312) 391-9206
Entity
Organization

Contact information

Practice address
1624 W DIVISION ST APT 208, CHICAGO, IL 60622-3908
(312) 391-9206
Mailing address
516 N OGDEN AVE # 195, CHICAGO, IL 60642-6421

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary

Other

Enumeration date
01/21/2025
Last updated
01/21/2025
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