MEDICARE: NORTHSHORE MEDICAL PRODUCT COMPANY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1588247795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHSHORE MEDICAL PRODUCT COMPANY

Provider Business Mailing Address
First Line	:	1745 E 87TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-2741
Country	:	US
Telephone Number	:	773-734-8998
Fax Number	:

Provider Business Practice Location Address
First Line	:	1745 E 87TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-2741
Country	:	US
Telephone Number	:	773-734-8998
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	FELIX PARKER
Credential	:
Telephone Number	:	773-734-8998

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	05/05/2021

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Directions to “NORTHSHORE MEDICAL PRODUCT COMPANY ” Practice Location

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