Independent for Life, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

203.000841 Issued in IL

Legal business name

INDEPENDENT FOR LIFE, INC.

Practice address

4015 Progress Blvd
Peru, IL 61354-1123

Phone

(866) 494-1948

Fax

(815) 780-1688

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert Nudd Jr.

Title

Manager

Phone

(866) 494-1948

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260835200000",
    "number": "1669522967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541123",
            "telephone_number": "866-494-1948",
            "fax_number": "815-780-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4015 PROGRESS BLVD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541123",
            "telephone_number": "866-494-1948",
            "fax_number": "815-780-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT FOR LIFE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2009-12-15",
        "status": "A",
        "authorized_official_last_name": "NUDD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "866-494-1948",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203.000841",
            "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 Dec 15, 2009; 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.