Mo Med Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MO MED SUPPLY LLC

Practice address

6160 N Cicero Ave Ste 308
Chicago, IL 60646-4331

Phone

(314) 440-1304

Fax

(314) 200-9906

NPI assigned

Oct 3, 2023

Organization subpart

No

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

Authorized official

Name

Syed H Kidwai

Title

Authorize Official

Phone

(224) 409-7428

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

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

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1972383388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6160 N CICERO AVE STE 308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464331",
            "telephone_number": "636-244-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6160 N CICERO AVE STE 308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464331",
            "telephone_number": "314-440-1304",
            "fax_number": "314-200-9906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MO MED SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-03",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "KIDWAI",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "AUTHORIZE OFFICIAL",
        "authorized_official_telephone_number": "224-409-7428"
    },
    "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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• Mo S Wellness Clinic LLC
• Cailian Mo
• James Gin Mo, MD
• Koany C Mo, D.O.
• Samuel Mo, MD

• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, 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 Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.