Organization
MK ORTHO EQUIPMENT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERI TARANTINO (AUTHORIZING AGENT)
(913) 526-5282
Entity
Organization
Contact information
Practice address
1511 S INDIANA AVE UNIT G, CHICAGO, IL 60605-3358
(630) 330-9596
Mailing address
1511 S INDIANA AVE UNIT G, CHICAGO, IL 60605-3358
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
05/20/2019
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