Provider Demographics
NPI:1184862484
Name:ADVANTAGE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:ADVANTAGE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:475-151-5058
Mailing Address - Street 1:2312 TOUHY AVE
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VLG
Mailing Address - State:IL
Mailing Address - Zip Code:60007-5329
Mailing Address - Country:US
Mailing Address - Phone:847-669-1500
Mailing Address - Fax:847-669-1555
Practice Address - Street 1:2312 TOUHY AVE
Practice Address - Street 2:
Practice Address - City:ELK GROVE VLG
Practice Address - State:IL
Practice Address - Zip Code:60007-5329
Practice Address - Country:US
Practice Address - Phone:847-669-1500
Practice Address - Fax:847-669-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203001190OtherSTATE LICENSE
IL6457130001Medicare Oscar/Certification