Medstate Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

68750911 Issued in IL

Legal business name

MEDSTATE INC.

Practice address

496 S Beacon LN
Round Lake, IL 60073-5408

Phone

(847) 740-2774

Fax

(847) 201-2578

NPI assigned

Nov 19, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ireneo Ongcal

Title

President

Phone

(847) 962-0688

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353283200000",
    "number": "1093059792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 S BEACON LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735408",
            "telephone_number": "847-740-2774",
            "fax_number": "847-201-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 S BEACON LN",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735408",
            "telephone_number": "847-740-2774",
            "fax_number": "847-201-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTATE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A",
        "authorized_official_last_name": "ONGCAL",
        "authorized_official_first_name": "IRENEO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-962-0688"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "68750911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Round Lake, IL
• Providers in Round Lake, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.