Chicago Medical Alliance LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2092906 Issued in IL

Legal business name

CHICAGO MEDICAL ALLIANCE LLC

Practice address

2219 W Chicago Ave Apt 1F
Chicago, IL 60622-4795

Phone

(773) 366-2159

Fax

(773) 862-6300

NPI assigned

May 3, 2011

Last updated

May 3, 2011By the provider in NPPES

Organization subpart

Yes

Parent organization

CHICAGO MEDICAL ALLIANCE LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Vitali Chaian

Title

Member

Phone

(773) 366-2159

Specialties & licenses 1

Addresses

Part of

Chicago Medical Alliance LLC

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1304380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304380800000",
    "number": "1073805552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2629 W CHICAGO AVE # IF",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228182",
            "telephone_number": "773-366-2159",
            "fax_number": "773-862-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 W CHICAGO AVE APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606224795",
            "telephone_number": "773-366-2159",
            "fax_number": "773-862-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO MEDICAL ALLIANCE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHICAGO MEDICAL ALLIANCE LLC",
        "enumeration_date": "2011-05-03",
        "last_updated": "2011-05-03",
        "status": "A",
        "authorized_official_last_name": "CHAIAN",
        "authorized_official_first_name": "VITALI",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-366-2159"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "2092906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.