MEDICARE: NANACARE 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
2	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1912872318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NANACARE INC

Provider Business Mailing Address
First Line	:	6961 N OAKLEY AVE APT 108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4724
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6961 N OAKLEY AVE APT 108
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-4724
Country	:	US
Telephone Number	:	551-344-7630
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	FNU MOHAMMED MASOOD
Credential	:
Telephone Number	:	551-344-7630

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	04/21/2026

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Directions to “NANACARE INC ” Practice Location

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