Provider Demographics
NPI:1417904467
Name:ENHANCED MEDICAL SUPPLIES CO
Entity Type:Organization
Organization Name:ENHANCED MEDICAL SUPPLIES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-837-1800
Mailing Address - Street 1:300 N SEYMOUR AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-2343
Mailing Address - Country:US
Mailing Address - Phone:847-837-1800
Mailing Address - Fax:847-837-1888
Practice Address - Street 1:300 N SEYMOUR AVE
Practice Address - Street 2:SUITE E
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-2343
Practice Address - Country:US
Practice Address - Phone:847-837-1800
Practice Address - Fax:847-837-1888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies