MEDICARE: EAST SHORELINE SUPPLIES 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1902777600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST SHORELINE SUPPLIES INC

Provider Business Mailing Address
First Line	:	1699 WALL ST STE 550C
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1699 WALL ST STE 550C
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056-5786
Country	:	US
Telephone Number	:	213-568-8302
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	UNKNOWN MUHAMMAD SHAHID ALI
Credential	:
Telephone Number	:	213-568-8302

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	12/16/2025

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Directions to “EAST SHORELINE SUPPLIES INC ” Practice Location

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