Provider Demographics
NPI:1952466757
Name:AB4U, INC.
Entity Type:Organization
Organization Name:AB4U, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VASILI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEGELSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-877-0565
Mailing Address - Street 1:5428 EBONY CT
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-6339
Mailing Address - Country:US
Mailing Address - Phone:847-877-0565
Mailing Address - Fax:
Practice Address - Street 1:5325 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-2531
Practice Address - Country:US
Practice Address - Phone:773-271-5325
Practice Address - Fax:773-271-2455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000458332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633172OtherBCBSIL
IL=========Medicaid
IL=========Medicaid