MEDICARE: AXIOS MEDICAL EQUIPMENT, INC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	054015167	IL
3	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2021583	OTHER		PK

General Provider Information

NPI Number	:	1841276870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIOS MEDICAL EQUIPMENT, INC

Provider Business Mailing Address
First Line	:	2003 W FULTON ST
Second Line	:	4TH FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60612-2345
Country	:	US
Telephone Number	:	312-738-2330
Fax Number	:	312-738-2395

Provider Business Practice Location Address
First Line	:	2003 W FULTON ST
Second Line	:	4TH FLOOR
City	:	CHICAGO
State	:	IL
Zip	:	60612-2345
Country	:	US
Telephone Number	:	312-202-3500
Fax Number	:	312-229-0115

Authorized Official
Title or Position	:	CEO
Name	:	ARISTOTLE KORNAROS
Credential	:
Telephone Number	:	630-699-2400

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	12/28/2022

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