MEDICARE: MEDWIN MED SUPPL INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		IL

General Provider Information

NPI Number	:	1447440227
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDWIN MED SUPPL INC

Provider Business Mailing Address
First Line	:	6122 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-3805
Country	:	US
Telephone Number	:	773-775-7899
Fax Number	:	773-358-7727

Provider Business Practice Location Address
First Line	:	6122 N MILWAUKEE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-3805
Country	:	US
Telephone Number	:	773-775-7899
Fax Number	:	773-358-7727

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. SIDDIQ AHMED
Credential	:
Telephone Number	:	773-775-7899

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	01/08/2008

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