89 Ill. Adm. Code 686.715
Assistive Equipment Provider Requirements
Section 686
Section 686.715 Assistive
Equipment Provider Requirements
All assistive equipment
providers must:
a) meet the approval of the customer and counselor;
b) submit a completed 1413A − Waiver Program Provider
Agreement for Participation in the Illinois Medical Assistance Program form;
and
c) submit a completed W-9 Request for Taxpayer Identification
Number and Certificate.