Organization
NICA MEDICAL EQUIPMENT SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTIANA UDOH (GENERAL MANAGER)
(773) 671-5162
Entity
Organization
Contact information
Practice address
28 W LAKE ST, SUITE 7, ADDISON, IL 60101-2709
(630) 628-7004
(630) 628-6106
Mailing address
28 W LAKE ST, SUITE 7, ADDISON, IL 60101-2709
(630) 628-7004
(630) 628-6106
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13803551001
—
IL
Enumeration date
05/08/2007
Last updated
01/02/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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