Provider Demographics
NPI:1497028369
Name:INNOVATIVE MEDICAL SOLUTIONS INC
Entity Type:Organization
Organization Name:INNOVATIVE MEDICAL SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUPT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-461-1715
Mailing Address - Street 1:418 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:GLENCOE
Mailing Address - State:IL
Mailing Address - Zip Code:60022-2124
Mailing Address - Country:US
Mailing Address - Phone:847-461-1715
Mailing Address - Fax:
Practice Address - Street 1:418 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:GLENCOE
Practice Address - State:IL
Practice Address - Zip Code:60022-2124
Practice Address - Country:US
Practice Address - Phone:847-461-1715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies