Provider Demographics
NPI:1649992587
Name:MIKLAURESCH DME SERVICES LLC
Entity type:Organization
Organization Name:MIKLAURESCH DME SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPEJO
Authorized Official - Suffix:
Authorized Official - Credentials:SPECIALISTS
Authorized Official - Phone:872-813-4800
Mailing Address - Street 1:3245 GROVE AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3476
Mailing Address - Country:US
Mailing Address - Phone:872-813-4800
Mailing Address - Fax:773-439-2552
Practice Address - Street 1:3245 GROVE AVE STE 205
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3476
Practice Address - Country:US
Practice Address - Phone:872-813-4800
Practice Address - Fax:773-439-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-16
Last Update Date:2024-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies