Organization
MO MED SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED H KIDWAI (AUTHORIZE OFFICIAL)
(224) 409-7428
Entity
Organization
Contact information
Practice address
6160 N CICERO AVE STE 308, CHICAGO, IL 60646-4331
(314) 440-1304
(314) 200-9906
Mailing address
6160 N CICERO AVE STE 308, CHICAGO, IL 60646-4331
(636) 244-0187
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
11/25/2025
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