Nica Medical Equipment Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

NICA MEDICAL EQUIPMENT SUPPLY

Practice address

28 W Lake St
Suite 7
Addison, IL 60101-2709

Phone

(630) 628-7004

Fax

(630) 628-6106

NPI assigned

May 8, 2007

Last updated

Jan 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Christiana Udoh

Title

General Manager

Phone

(773) 671-5162

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230854400000",
    "number": "1982817565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 W LAKE ST",
            "address_2": "SUITE 7",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012709",
            "telephone_number": "630-628-7004",
            "fax_number": "630-628-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 W LAKE ST",
            "address_2": "SUITE 7",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012709",
            "telephone_number": "630-628-7004",
            "fax_number": "630-628-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICA MEDICAL EQUIPMENT SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2009-01-02",
        "status": "A",
        "authorized_official_last_name": "UDOH",
        "authorized_official_first_name": "CHRISTIANA",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "773-671-5162",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13803551001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.