Healthcare Provider Details

I. General information

NPI: 1942002142
Provider Name (Legal Business Name): MA MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 W PETERSON AVE STE 309
CHICAGO IL
60659-3315
US

IV. Provider business mailing address

3525 W PETERSON AVE STE 309
CHICAGO IL
60659-3315
US

V. Phone/Fax

Practice location:
  • Phone: 872-325-8027
  • Fax:
Mailing address:
  • Phone: 872-325-8027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MUQEED AHMED
Title or Position: MANAGER
Credential:
Phone: 872-325-8027