Provider Demographics
NPI:1114063229
Name:DELNOR HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:DELNOR HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEDESCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-513-0370
Mailing Address - Street 1:964 N 5TH AVE
Mailing Address - Street 2:BUILDING C
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1204
Mailing Address - Country:US
Mailing Address - Phone:630-513-0370
Mailing Address - Fax:630-513-8462
Practice Address - Street 1:964 N 5TH AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1204
Practice Address - Country:US
Practice Address - Phone:630-513-0370
Practice Address - Fax:630-513-8462
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELNOR COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-29
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000639332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========006Medicaid
IL=========006Medicaid