Healthcare Provider Details
I. General information
NPI: 1851243919
Provider Name (Legal Business Name): PRIME CHOICE MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6326 N CICERO AVE STE 104
CHICAGO IL
60646-4418
US
IV. Provider business mailing address
6326 N CICERO AVE STE 104
CHICAGO IL
60646-4418
US
V. Phone/Fax
- Phone: 773-551-8065
- Fax: 224-335-7708
- Phone: 773-551-8065
- Fax: 224-335-7708
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 | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BC3200X |
| Taxonomy | Customized Equipment (DME) |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BD1200X |
| Taxonomy | Dialysis Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BN1400X |
| Taxonomy | Nursing Facility Supplies (DME) |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CHRISTINA
ANASTASIOU
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 773-551-8065