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General NPI Number Information
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NPI Number | 1396290417
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Entity Type | Organization
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Legal Business Name | MIDWEST MEDICAL SUPPLIES & EQUIPMENT LLC
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 12/11/2020
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Provider Practice Location Address
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Address Line | ATTN: GRACE EKONG AT EAST POINT BUILDING 6101 N. SHERIDAN RD, EAST SUITE 9B
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City | CHICAGO
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State | IL
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Zip | 60660-2808
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Country | US
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Telephone | 773-973-1236
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Fax | 773-974-6157
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Provider Business Mailing Address
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Address Line | ATTN: GRACE EKONG AT EAST POINT BUILDING 6101 N. SHERIDAN RD, EAST SUITE 9B
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City | CHICAGO
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State | IL
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Zip | 60660-2808
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Country | US
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Telephone | 773-973-1236
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Fax | 773-974-6157
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Authorized Official
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Title or Position | CEO
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Name | MRS. GRACE E EKONG
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Credential | MS CHEMISTRY
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Telephone | 773-973-1236
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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