Organization
MEDICAL SUPPLY COMPANY OF ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHERMAN F DELLA CPA (CFO)
(773) 509-0681
Entity
Organization
Contact information
Practice address
5061 N PULASKI RD, SUITE 204, CHICAGO, IL 60630-2706
(773) 487-1186
(773) 478-1192
Mailing address
5061 N PULASKI RD, SUITE 204, CHICAGO, IL 60630-2706
(773) 487-1186
(773) 478-1192
Taxonomy
Speciality
Code
Description
License number
State
332BN1400X
Nursing Facility Supplies (DME)
Primary
28771362
IL
Other
Enumeration date
04/04/2007
Last updated
12/04/2007
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