Provider Demographics
NPI:1548238793
Name:DOCTORS CHOICE,INC.
Entity Type:Organization
Organization Name:DOCTORS CHOICE,INC.
Other - Org Name:DOCTORS CHOICE HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-617-5949
Mailing Address - Street 1:600 W CERMAK RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2268
Mailing Address - Country:US
Mailing Address - Phone:312-666-1111
Mailing Address - Fax:312-666-1121
Practice Address - Street 1:600 W CERMAK RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-2268
Practice Address - Country:US
Practice Address - Phone:312-666-1111
Practice Address - Fax:312-666-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-12
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000412332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL4610020001Medicare NSC