Organization
NORTH SHORE MEDICAL SUPPLIES CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAT SIDDIQUI (OWNER)
(773) 262-4432
Entity
Organization
Contact information
Practice address
7455 NORTH WESTERN AVE, CHICAGO, IL 60645
(773) 262-4432
(773) 262-4712
Mailing address
7455 N WESTERN AVE, CHICAGO, IL 60645-1735
(773) 262-4432
(773) 262-4712
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000319
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001633212
BCBS
IL
Enumeration date
01/23/2007
Last updated
06/20/2008
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