Healthcare Provider Details

I. General information

NPI: 1225370554
Provider Name (Legal Business Name): MEDICAL GEAR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 06/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3949 N PULASKI RD
CHICAGO IL
60641-2932
US

IV. Provider business mailing address

3501 ALGONQUIN RD. SUITE 560
ROLLING MEADOWS IL
60008
US

V. Phone/Fax

Practice location:
  • Phone: 773-283-0090
  • Fax:
Mailing address:
  • Phone: 847-847-4751
  • Fax: 847-960-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: ANITA BASA
Title or Position: EXEC. DIRECTOR
Credential:
Phone: 773-283-0090