NPIMap

Organization Active NPI

Windham Medical Supplies

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
National Provider Identifier
1407920473
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
WINDHAM MEDICAL SUPPLIES
Doing business as
Matt Windham Jr
Practice address
2056 East 71St Street
Chicago, IL 60649-2117
Phone
(773) 288-2844
Fax
(773) 288-2848
NPI assigned
Nov 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Authorized official

Name
Mr. Matt Windham Jr.NPI 1790886398
Title
Owner
Phone
(773) 288-2844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2056 East 71St Street
Chicago, IL 60649-2117

Mailing address

2056 East 71St Street
Chicago, IL 60649-2117
Phone (773) 288-2844

Other identifiers 1

IdentifierTypeStateIssuer
RFP797FSS990025R4OtherVA NATIONAL ACQUICITION C

Other names 1

  • Matt Windham Jr Doing business as

National Provider Directory

National Provider Directory

Locations

2056 E 71st St
Chicago, IL 60649
Phone (773) 288-2844

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206662400000",
    "number": "1407920473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2056 EAST 71ST STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492117",
            "telephone_number": "773-288-2844",
            "fax_number": "773-288-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2056 EAST 71ST STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606492117",
            "telephone_number": "773-288-2844",
            "fax_number": "773-288-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WINDHAM MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2008-03-28",
        "status": "A",
        "authorized_official_last_name": "WINDHAM",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-288-2844",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA NATIONAL ACQUICITION C",
            "identifier": "RFP797FSS990025R4",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Matt Windham Jr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 28, 2008; 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.