Provider Demographics
NPI:1689628273
Name:BREEZE TECHNOLOGY & ACCESSORIES, INC.
Entity Type:Organization
Organization Name:BREEZE TECHNOLOGY & ACCESSORIES, INC.
Other - Org Name:BREEZE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:WENDI
Authorized Official - Middle Name:L
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-209-6402
Mailing Address - Street 1:660 MCHENRY RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-9220
Mailing Address - Country:US
Mailing Address - Phone:847-765-4008
Mailing Address - Fax:847-765-4007
Practice Address - Street 1:3029 N BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-2024
Practice Address - Country:US
Practice Address - Phone:847-765-4008
Practice Address - Fax:847-765-4007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000792332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200078240AMedicaid
NC5467900005Medicare NSC
MO5467900001Medicare NSC
AL5467900006Medicare NSC
TX5467900003Medicare NSC
IL5467900010Medicare NSC
FL5467900008Medicare NSC
OK5467900004Medicare NSC