Provider Demographics
NPI:1679680797
Name:A TO Z MOBILITY AND MEDICAL EQUIP
Entity type:Organization
Organization Name:A TO Z MOBILITY AND MEDICAL EQUIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANTUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:779-234-9072
Mailing Address - Street 1:23838 W INDUSTRIAL DR N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-8516
Mailing Address - Country:US
Mailing Address - Phone:779-234-9072
Mailing Address - Fax:779-234-9063
Practice Address - Street 1:23838 W INDUSTRIAL DR N
Practice Address - Street 2:STE 200
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-8516
Practice Address - Country:US
Practice Address - Phone:779-234-9072
Practice Address - Fax:779-234-9063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.001831171WH0202X, 332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001Medicaid
5089480001Medicare PIN