Havana Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

HAVANA MEDICAL SUPPLY

Practice address

1807 Sherman Blvd
Crystal Lake, IL 60014-2456

Phone

(847) 875-5957

NPI assigned

Oct 18, 2021

Organization subpart

No

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

Authorized official

Name

Keri Tarantino Jr.

Title

Authorizing Agent

Phone

(913) 526-5282

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rolando Izquierdo Jr., M.D.

  • Orthopaedic Surgery Physician
  • Algonquin, IL
  • NPI 1134138027
  NPD
• Rebecca E Cheski, ATC

  • Athletic Trainer
  • Crystal Lake, IL
  • NPI 1306235882
  NPD (past)

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634515200000",
    "number": "1932862810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 SHERMAN BLVD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 SHERMAN BLVD",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600142456",
            "telephone_number": "847-875-5957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVANA MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A",
        "authorized_official_last_name": "TARANTINO",
        "authorized_official_first_name": "KERI",
        "authorized_official_title_or_position": "AUTHORIZING AGENT",
        "authorized_official_telephone_number": "913-526-5282",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann M Hart, MS,PT
• Theodore Joseph Hartman, OTR/L
• Hasan Vision Care PLLC
• Anne Haseman, PT
• Steven Frederick Hatcher, D.C.
• Kristin Havemann, DPT
• Timothy G Havenhill, M.D.
• Catherine Agnes Hawkins
• Timothy J Hayes, PSY.D.
• Cameron Hays, MD

• Durable Medical Equipment & Medical Supplies in Crystal Lake, IL
• Providers in Crystal 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 Oct 18, 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.