Healthcare Provider Details
I. General information
NPI: 1801717293
Provider Name (Legal Business Name): MASBI DREAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2046 W DEVON AVE APT 2
CHICAGO IL
60659-2241
US
IV. Provider business mailing address
2046 W DEVON AVE APT 2
CHICAGO IL
60659-2241
US
V. Phone/Fax
- Phone: 999-999-9999
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BAIG
MIRZA
Title or Position: MANAGER
Credential:
Phone: 999-999-9999