Provider Demographics
NPI:1093130122
Name:NILAN MEDICAL LLC
Entity Type:Organization
Organization Name:NILAN MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:A
Authorized Official - Last Name:JEFFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-497-0831
Mailing Address - Street 1:1215 W NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-3130
Mailing Address - Country:US
Mailing Address - Phone:708-497-0831
Mailing Address - Fax:
Practice Address - Street 1:1215 W NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-3130
Practice Address - Country:US
Practice Address - Phone:708-497-0831
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies