MEDICARE: WINDY CITY MEDICAL SUPPLY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)
4	343800000X	Secured Medical Transport (VAN)
5	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1376827931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDY CITY MEDICAL SUPPLY INC.

Provider Business Mailing Address
First Line	:	529 ASHLAND AVE
Second Line	:	SUITE B
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1639
Country	:	US
Telephone Number	:	708-585-0530
Fax Number	:

Provider Business Practice Location Address
First Line	:	529 ASHLAND AVE
Second Line	:	SUITE B
City	:	CHICAGO HEIGHTS
State	:	IL
Zip	:	60411-1639
Country	:	US
Telephone Number	:	708-585-0530
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHEN AKPAN
Credential	:
Telephone Number	:	708-585-0530

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	09/30/2011

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