Healthcare Provider Details

I. General information

NPI: 1104755784
Provider Name (Legal Business Name): PEARLCARE MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LAKE ST STE 1D
ROSELLE IL
60172-3370
US

IV. Provider business mailing address

1350 LAKE ST STE 1D
ROSELLE IL
60172-3370
US

V. Phone/Fax

Practice location:
  • Phone: 630-290-0396
  • Fax:
Mailing address:
  • Phone: 630-290-0396
  • 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: SYED A HASHMI
Title or Position: OWNER
Credential:
Phone: 630-290-0396