Provider Demographics
NPI:1003812777
Name:SERVICE MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:SERVICE MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCILINGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-848-1900
Mailing Address - Street 1:PO BOX 266
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-0266
Mailing Address - Country:US
Mailing Address - Phone:888-848-1900
Mailing Address - Fax:630-324-4242
Practice Address - Street 1:5017 CHASE AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-4014
Practice Address - Country:US
Practice Address - Phone:888-848-1900
Practice Address - Fax:630-789-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000568332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL215838800OtherDEPT OF LABOR
ID01671321OtherBLUE CROSS BLUE SHIELD
IL215838800OtherDEPT OF LABOR