MEDICARE: STREAMLINE MEDICAL, LLC

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	:	1912241639
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STREAMLINE MEDICAL, LLC

Provider Business Mailing Address
First Line	:	1626 W LAKE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2500
Country	:	US
Telephone Number	:	773-547-9499
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 W LAKE ST
Second Line	:	SUITE 1
City	:	CHICAGO
State	:	IL
Zip	:	60612-2500
Country	:	US
Telephone Number	:	773-547-9499
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MATTHEW D MONTANARI
Credential	:
Telephone Number	:	773-805-9200

Provider Enumeration Date	:	11/19/2012
Last Update Date	:	11/19/2012

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