MEDICARE: SIAW ENTERPRISES, LLC

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	:	1932441763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIAW ENTERPRISES, LLC

Provider Business Mailing Address
First Line	:	2829 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3513
Country	:	US
Telephone Number	:	773-823-1802
Fax Number	:	773-823-1814

Provider Business Practice Location Address
First Line	:	2829 W CERMAK RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60623-3513
Country	:	US
Telephone Number	:	773-823-1802
Fax Number	:	773-823-1814

Authorized Official
Title or Position	:	OWNER
Name	:	MARGARET SIAW
Credential	:
Telephone Number	:	630-209-0987

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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