Stuart Kuntzelman, ATP
Individual provider Active NPI Customized Equipment (DME) · Juda, WI
NPI 1811512437 · NPPES record last updated Jun 9, 2020
Key facts
- NPI
- 1811512437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Customized Equipment (DME) 332BC3200X
- License
- 203.002025 (IL)
- Practice address
- W2678 Town Center Rd
Juda, WI 53550-9565 - Phone
- (630) 806-3036
- NPI assigned
- Jun 9, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 203.002025 | IL | MD | Customized Equipment (DME) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| S&J Services and Repairs, LLC | Customized Equipment | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | 203.002025 | IL | Yes |
Addresses
Primary practice location
W2678 Town Center Rd
Juda, WI 53550-9565
Mailing address
W2678 Town Center Rd
Juda, WI 53550-9565
Phone (630) 806-3036
Other providers in Juda, WI
- Paige Bowers
- Michelle Broger
- Tanya Lawson
- Kathryn Ann Reidenbach
- S&J Services and Repairs, LLC
- School District of Juda
All providers in Juda, WI · Customized Equipment (DME) in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.