Organization
ACTIVA MEDICAL SUPPLIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA SMEKHOV (OWNER)
(312) 266-6160
Entity
Organization
Contact information
Practice address
2212 W NORTH AVE, CHICAGO, IL 60647-8467
(312) 266-6160
Mailing address
1901 N MOHAWK ST, CHICAGO, IL 60614-5219
(312) 266-6160
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000704
IL
Other
Enumeration date
08/12/2006
Last updated
07/06/2009
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