Healthcare Provider Details

I. General information

NPI: 1881571065
Provider Name (Legal Business Name): NOVA INNOVATION SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 W HIGGINS RD SUITE 470
ROSEMONT IL
60018
US

IV. Provider business mailing address

9400 W HIGGINS RD SUITE 470
ROSEMONT IL
60018
US

V. Phone/Fax

Practice location:
  • Phone: 312-451-0468
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: UNKNOWN MUHAMMAD SHAHID ALI
Title or Position: MANAGER
Credential:
Phone: 312-451-0468