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General NPI Number Information
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NPI Number | 1902777600
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Entity Type | Organization
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Legal Business Name | EAST SHORELINE SUPPLIES INC
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 1699 WALL ST STE 550C
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-5786
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Country | US
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Telephone | 213-568-8302
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Fax |
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Provider Business Mailing Address
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Address Line | 1699 WALL ST STE 550C
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | UNKNOWN MUHAMMAD SHAHID ALI
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Credential |
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Telephone | 213-568-8302
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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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