NPIMap

Organization Active NPI

Activstyle LLC

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
National Provider Identifier
1407847882
Registry record updated Oct 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
203000538 Issued in IL
Legal business name
ACTIVSTYLE LLC
Practice address
2139 W 95TH St
Chicago, IL 60643-1018
Phone
(773) 783-4600
Fax
(773) 783-8333
NPI assigned
Nov 3, 2005
Reactivated
Mar 5, 2013
Last updated
Oct 31, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ACTIVSTYLE HOLDING COMPANYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2025

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

Authorized official

Name
Darrell Douglas Rawlings
Title
Ceo
Phone
(612) 895-7815

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 203000538 IL Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 203.001527 IL

Addresses

Primary practice location

2139 W 95TH St
Chicago, IL 60643-1018

Mailing address

1055 Westgate Dr Ste 100
Saint Paul, MN 55114-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130515000497 IL DME Supplier - Medical Supply Company 1951422302 Practice locations: Chicago, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Activstyle LLC2139 W 95TH St, Chicago, IL 60643-1018(773) 783-4600 Commodes, Urinals, Bedpans|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Surgical Dressings Accepts assignmentParticipating since Jan 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Activstyle LLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2139 W 95th St
Chicago, IL 60643
Phone (773) 701-5743

9245 S Ashland Ave
Chicago, IL 60620
Phone (773) 783-4600

1701 Broadway St NE
Minneapolis, MN 55413

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1407847882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 WESTGATE DR STE 100",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 W 95TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431018",
            "telephone_number": "773-783-4600",
            "fax_number": "773-783-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVSTYLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ACTIVSTYLE HOLDING COMPANY",
        "enumeration_date": "2005-11-03",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "deactivation_date": "2012-12-28",
        "reactivation_date": "2013-03-05",
        "status": "A",
        "authorized_official_last_name": "RAWLINGS",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-895-7815"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203000538",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "IL",
            "license": "203.001527",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.