Kinnick Medical Limited

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203.001676 Issued in IL

Legal business name

KINNICK MEDICAL LIMITED

Practice address

17W725 Butterfield Rd Ste D
Oakbrook Terrace, IL 60181-4279

Phone

(630) 656-1264

Fax

(773) 305-0949

NPI assigned

Oct 13, 2015

Organization subpart

No

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

Authorized official

Name

Mike R Rodriguez

Title

Principal

Phone

(773) 425-0400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1444694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1588035851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W725 BUTTERFIELD RD STE D",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814279",
            "telephone_number": "630-656-1264",
            "fax_number": "773-305-0949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W725 BUTTERFIELD RD STE D",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601814279",
            "telephone_number": "630-656-1264",
            "fax_number": "773-305-0949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINNICK MEDICAL LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-13",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "773-425-0400"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.001676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.