KOFFEL MEDICAL SUPPLY INC (NPI# 1821088964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821088964 |
| Entity Type | Organization |
| Organization Name | KOFFEL MEDICAL SUPPLY INC |
| Practice Address |
1003 W Park Ave Libertyville IL 60048-2550 |
| Practice Telephone | 8478168000 |
| Practice Fax Number | 8478168606 |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JOHN W KOFFEL (PRESIDENT) |
| Authorized Official Telephone | 8478168000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332BD1200X |
Durable Medical Equipment & Medical Supplies Specialization: Dialysis Equipment & Supplies |
IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 59379 | 05 | |
| TN | 4581798 | 05 | |
| LA | 1531235 | 05 | |
| GA | 00673978X | 05 | |
| OH | 0877243 | 05 | |
| KY | 90002692 | 05 | |
| MS | 0440301 | 05 | |
| DC | 0701390 | 05 | |
| IA | 0944694 | 05 | |
| NJ | 3742601 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | KOFFEL MEDICAL SUPPLY INC | 1003 W Park Ave, Libertyville, IL 60048-2550 |
| Street Address |
1003 W PARK AVE |
| City | LIBERTYVILLE |
| State | IL |
| Zip Code | 60048-2550 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184119950 | Park Avenue Dental Professionals, PC | Dentist | 1001 W. Park Avenue, Libertyville, IL 60048 | 2018-06-25 |
| 1437643525 | Shanna Coyle | Registered Nurse | 1128 Jaimee Ln, Libertyville, IL 60048 | 2018-06-21 |
| 1366943672 | Jackie Rayyan | Behavior Technician | 917 Sherwood Drive, Suite 201, Lake Bluff, IL 60048 | 2018-02-22 |
| 1851804850 | Mary E. Linsey | Counselor | 34180 Highway 45, Libertyville, IL 60048 | 2017-11-13 |
| 1962929018 | Affinity Integrated Healthcare | Chiropractor | 736 Florsheim Dr, St 12, Libertyville, IL 60048 | 2017-08-29 |
| 1164946471 | Christianna Patterson | Speech-Language Pathologist | 1870 W Winchester Rd #203, Libertyville, IL 60048 | 2017-07-28 |
| 1962938407 | Kyle Winiger | Specialist/Technologist | 4551 West Gavin Lane, Libertyville, IL 60048 | 2017-05-03 |
| 1396291530 | Karyn Kolner | Physical Therapist | 860 W Winchester Rd, #108, Libertyville, IL 60048 | 2016-08-28 |
| 1477900785 | Medlogic LLC | Clinic/Center | 114 West Rockland Road, Suite 201, Libertyville, IL 60048 | 2016-05-17 |
| 1477926343 | Robert Mcnulty | Student in an Organized Health Care Education/Training Program | 1313 Crane Blvd, Libertyville, IL 60048 | 2015-11-02 |
| Find all providers in zip 60048 | ||||
| Taxonomy Code | 332BD1200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Dialysis Equipment & Supplies |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902424013 | Comfort Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 2419 W Jefferson St, Joliet, IL 60435-6462 | 2020-07-06 |
| 1124161633 | Koronell Enterprises Inc | Durable Medical Equipment & Medical Supplies | 601 N Williams St, B-1, Thornton, IL 60476-1097 | 2007-02-14 |
| 1770632960 | X-change Dialysis, Inc. | Durable Medical Equipment & Medical Supplies | 525 W Old Northwest Hwy, Suite 202c, Barrington, IL 60010-6814 | 2007-01-09 |
| 1245831197 | Thelifesupplies Inc | Durable Medical Equipment & Medical Supplies | 26117 S Countyfair Dr, Monee, IL 60449-8783 | 2020-11-06 |
| 1740837111 | Ashley's Helping Hands Inc. | Durable Medical Equipment & Medical Supplies | 610 W Root St, Chicago, IL 60609-2630 | 2019-08-21 |
| City | LIBERTYVILLE |
| Zip Code | 60048 |
Please comment or provide details below to improve the information on KOFFEL MEDICAL SUPPLY INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.