Provider Demographics
NPI:1770576902
Name:BIOCONCEPTS INC
Entity type:Organization
Organization Name:BIOCONCEPTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-986-0007
Mailing Address - Street 1:100 TOWER DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5777
Mailing Address - Country:US
Mailing Address - Phone:630-986-0007
Mailing Address - Fax:630-986-0151
Practice Address - Street 1:100 TOWER DR
Practice Address - Street 2:SUITE 101
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-5777
Practice Address - Country:US
Practice Address - Phone:630-986-0007
Practice Address - Fax:630-986-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL213000021335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid