Organization Active NPI

Medline Industries, LP

Durable Medical Equipment & Medical Supplies
Grayslake, IL

National Provider Identifier

1811997638

Registry record updated Mar 4, 2022

On this page

Key facts
NPPES NPI Registry
Medicare participation
Laboratory certificates & supplier records
National Provider Directory
Ownership & related parties
NPI Registry JSON
Other providers in Grayslake, IL
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License: 203001682 Issued in IL
Legal business name: MEDLINE INDUSTRIES, LP
Practice address: 2200 Cornerstone Pkwy
Grayslake, IL 60030-9712
Phone: (224) 327-8800
NPI assigned: Jul 22, 2005
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Mar 4, 2022

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

Authorized official

Name: James Michael Boyle
Title: Authorized Person
Phone: (844) 265-6512

Specialties & licenses 2

Specialty (taxonomy)	Code	License	State	Primary
Durable Medical Equipment & Medical Supplies	332B00000X	203001682	IL	Primary
Durable Medical Equipment & Medical Supplies	332B00000X

Addresses

Primary practice location

2200 Cornerstone Pkwy
Grayslake, IL 60030-9712

Mailing address

3 Lakes Dr
Northfield, IL 60093-2753
Phone (844) 265-6512

Other practice location 1

1501 Harris Rd
Libertyville, IL 60048-2433
Phone (866) 356-4997

Other identifiers 39

Identifier	Type	State
1811997638	Medicaid	WA
1811997638	Medicaid	UT
1811997638	Medicaid	DE
90032335	Medicaid	KY
00	Medicaid	NE
00410369	Medicaid	MS
1021896	Medicaid	AK
1811997638	Medicaid	WI
1811997638	Medicaid	IA
194904716	Medicaid	AR
2429400	Medicaid	LA
98000060	Medicaid	CO
143546900	Medicaid	WY
1811997638	Medicaid	ID
1811997638	Medicaid	ME
0009052300005	Medicaid	PA
00457949A	Medicaid	GA
00680891	Medicaid	NY
036021	Medicaid	AZ
0400435	Medicaid	OH
1811997638	Medicaid	MN
1811997638	Medicaid	AL
021743300	Medicaid	FL
100793800A	Medicaid	OK
1811997638	Medicaid	VA
5096901	Medicaid	NJ
000T0700	Medicaid	NM
0428930	Medicaid	RI
100441690A	Medicaid	KS
1811997638	Medicaid	MT
0623240	Medicaid	CA
100025130A	Medicaid	IN
100973800A	Medicaid	OK
3539772	Medicaid	TN
620803601	Medicaid	MO
001	Medicaid	IL
033388300	Medicaid	MD
1811997638	Medicaid	NV
3098855	Medicaid	NH

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Enrolled in IL

Enrollment records 1

Enrollment ID	State	Provider type	PAC ID	Details
O20100930026521	IL	DME Supplier - Medical Supply Company	2466430178	Practice locations: Grayslake, IL

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

Supplier	Supplies	Medicare assignment
Medline Industries LP2200 Cornerstone Pkwy, Grayslake, IL 60030-9712(224) 327-8800	Automatic Ext Defibrillator (AEDS) and/or Supplies\|Commodes, Urinals, Bedpans\|Blood Glucose Monitors/Supplies (Mail Order)\|Neuromuscular Elect Stimulators (NMES)/Supplies\|Support Surfaces: Pressure Reducing Beds/Mats/Pads\|Traction Equipment\|(TENS) Transcutaneous Electrical Nerve Stimulators and/or …	Accepts assignmentParticipating since Jan 1, 2020

National Provider Directory

Tax ID family: Medline Industriesinc-3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Medline Industries, LP
- Durable Medical Equipment & Medical Supplies
- Perryville, MD
- NPI 1760243505
NPD tax ID
Medline Industries, LP
- Durable Medical Equipment & Medical Supplies
- Southaven, MS
- NPI 1952084238
NPD tax ID

Locations

5701 Promontory Pkwy
Ste 100
Tracy, CA 95377
Phone (800) 678-7852

2200 Cornerstone Pkwy
Grayslake, IL 60030
Phone (224) 327-8800

1501 Harris Rd
Libertyville, IL 60048
Phone (866) 356-4997

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Facility	Type	Role	Since
Saratoga HospitalSaratoga Springs, NY, CCN 335394	Skilled nursing facility	Adp of the SNF	Jan 1, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Wesley Health Care Center, Inc.
- Skilled Nursing Facility
- Saratoga Springs, NY
- NPI 1710977459
Adp of the SNF
CMS ownership

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646352000000",
    "number": "1811997638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 LAKES DR",
            "city": "NORTHFIELD",
            "state": "IL",
            "postal_code": "600932753",
            "telephone_number": "844-265-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CORNERSTONE PKWY",
            "city": "GRAYSLAKE",
            "state": "IL",
            "postal_code": "600309712",
            "telephone_number": "224-327-8800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Harris Rd",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600482433",
            "country_code": "US",
            "telephone_number": "866-356-4997",
            "fax_number": "866-202-1563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDLINE INDUSTRIES, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2022-03-04",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED PERSON",
        "authorized_official_telephone_number": "844-265-6512"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "203001682",
            "primary": true
        },
        {
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            "taxonomy_group": "",
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            "primary": false
        }
    ],
    "identifiers": [
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        {
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        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grayslake, IL

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
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.