Healthcare Provider Details
I. General information
NPI: 1639014871
Provider Name (Legal Business Name): MIDWESTERN STATES MOVERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7120 N SHERIDAN RD APT 207
CHICAGO IL
60626-2902
US
IV. Provider business mailing address
7120 N SHERIDAN RD APT 207
CHICAGO IL
60626-2902
US
V. Phone/Fax
- Phone: 773-289-0934
- Fax:
- Phone: 773-289-0934
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BD1200X |
| Taxonomy | Dialysis Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TOM
HERRY
Title or Position: MANAGER
Credential:
Phone: 773-289-0934