MJ Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MJ MEDICAL SUPPLY LLC

Practice address

7501 N Milwaukee Ave
Niles, IL 60714-3614

Phone

(847) 647-6752

Fax

(815) 301-9010

NPI assigned

Dec 20, 2012

Organization subpart

No

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

Authorized official

Name

John Lee

Title

Managing Partner

Phone

(847) 647-6752

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1093051914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143614",
            "telephone_number": "847-647-6752",
            "fax_number": "815-301-9010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143614",
            "telephone_number": "847-647-6752",
            "fax_number": "815-301-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MJ MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "847-647-6752"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Niles, IL
• Providers in Niles, 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 Dec 20, 2012; 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.