Organization
MEDICAL SUPPLY DEPOT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HINA CHOWDHRY (PRESIDENT)
(260) 418-8050
Entity
Organization
Contact information
Practice address
2662 N LINCOLN AVE, CHICAGO, IL 60614-1307
(773) 868-3994
Mailing address
2662 N LINCOLN AVE, CHICAGO, IL 60614-1307
(773) 868-3994
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1475809472
IL
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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