Amg Illinois LTD
Organization Active NPI Durable Medical Equipment & Medical Supplies · Gurnee, IL
NPI 1124262944 · NPPES record last updated Sep 9, 2009
Key facts
- NPI
- 1124262944
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- Legal business name
- AMG ILLINOIS LTD
- Practice address
- 45 Tower CT
Suite C
Gurnee, IL 60031-3376 - Phone
- (847) 623-3200
- Fax
- (847) 623-9168
- NPI assigned
- Apr 23, 2009
- Organization subpart
- No
Authorized official
- Name
- Jeffrey Bailet, MD
- Title
- President
- Phone
- (414) 647-6322
Other NPIs on the same Medicare enrollment 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090512000348 | IL | Part B Supplier - Clinic/Group Practice | 8527117027 |
Receives reassigned benefits from 62 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Zion, IL; Waukegan, IL; Round Lake Beach, IL; Lindenhurst, IL; Libertyville, IL; Gurnee, IL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Yes |
Addresses
Primary practice location
45 Tower CT
Suite C
Gurnee, IL 60031-3376
Mailing address
45 Tower CT
Suite C
Gurnee, IL 60031-3376
Phone (847) 623-3200
Other providers in Gurnee, IL
- Jorge J Almodovar
- Robert Alongi
- Nejd F Alsikafi
- Karina Alvarez Espinoza
- American Drug Stores LLC
- Amg Illinois LTD
- Amg Illinois LTD
- Mark J Amidei
- Melanie Amin
- Shuba Anantha
All providers in Gurnee, IL · Durable Medical Equipment & Medical Supplies in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.