Provider Demographics
NPI:1841276870
Name:AXIOS MEDICAL EQUIPMENT, INC
Entity type:Organization
Organization Name:AXIOS MEDICAL EQUIPMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARISTOTLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KORNAROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-699-2400
Mailing Address - Street 1:2003 W FULTON ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2345
Mailing Address - Country:US
Mailing Address - Phone:312-738-2330
Mailing Address - Fax:312-738-2395
Practice Address - Street 1:2003 W FULTON ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2345
Practice Address - Country:US
Practice Address - Phone:312-202-3500
Practice Address - Fax:312-229-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 332B00000X
IL0540151673336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
2021583OtherPK
IL=========002Medicaid
IL=========002Medicaid