Organization
CHICAGO MEDICAL ALLIANCE LLC
Active
Parent organization
CHICAGO MEDICAL ALLIANCE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHICAGO MEDICAL ALLIANCE LLC
Authorized official
VITALI CHAIAN (MEMBER)
(773) 366-2159
Entity
Organization
Contact information
Practice address
2219 W CHICAGO AVE APT 1F, CHICAGO, IL 60622-4795
(773) 366-2159
(773) 862-6300
Mailing address
2629 W CHICAGO AVE # IF, CHICAGO, IL 60622-8182
(773) 366-2159
(773) 862-6300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2092906
IL
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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