Mimi Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MIMI MEDICAL SUPPLY LLC

Practice address

1905 W Riverside Blvd
Rockford, IL 61103-1502

Phone

(872) 702-3523

NPI assigned

Aug 22, 2025

Organization subpart

No

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

Authorized official

Name

Heather MarlowNPI 1790636223

Title

Manager

Phone

(667) 284-7662

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Heather Marlow IV

  • Durable Medical Equipment & Medical Supplies
  • Harvard, IL
  • NPI 1790636223
  NPD Authorized official

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773187200000",
    "number": "1356229942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 W RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031502",
            "telephone_number": "872-702-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 W RIVERSIDE BLVD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611031502",
            "telephone_number": "872-702-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIMI MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A",
        "authorized_official_last_name": "MARLOW",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "667-284-7662"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger L Miller, M.D.
• Shawna M Mills, MSED, LCPC, NCC
• Milos Dental Care
• Jamie Lynn Milos, D.D.S.
• Steven Milos, M.D.
• Mindplexity Psychiatric Services, PLLC
• Mindset Matters
• Lynette Ann Mindt, NP
• Patrina Celeste Minella, PEL ILLINOIS SLP
• Patricia L Miner, NP

• Durable Medical Equipment & Medical Supplies in Rockford, IL
• Providers in Rockford, 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 Mar 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.