Organization
WILLOW MEDICAL DISTRIBUTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BLAIR (AUTHORIZED REPRESENTATIVE)
(844) 407-7544
Entity
Organization
Contact information
Practice address
19801 GOVERNORS HWY STE 160, FLOSSMOOR, IL 60422-4363
(844) 407-7544
Mailing address
2045 W GRAND AVE, STE B #97551, CHICAGO, IL 60612
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203.001976
IL
Other
Enumeration date
02/01/2018
Last updated
08/15/2022
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