Provider Demographics
NPI:1235569021
Name:TELA MEDICAL LLC
Entity Type:Organization
Organization Name:TELA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-964-9684
Mailing Address - Street 1:3701 COMMERCIAL AVE
Mailing Address - Street 2:SUITE 17
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1800
Mailing Address - Country:US
Mailing Address - Phone:847-964-9684
Mailing Address - Fax:847-964-9685
Practice Address - Street 1:3701 COMMERCIAL AVE
Practice Address - Street 2:SUITE 17
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1800
Practice Address - Country:US
Practice Address - Phone:847-964-9684
Practice Address - Fax:847-964-9685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment