MEDSOURCE LLC (NPI# 1730354531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730354531 |
| Entity Type | Organization |
| Organization Name | MEDSOURCE LLC |
| Practice Address |
700 N Sacramento Blvd Ste 120 Chicago IL 60612 |
| Mailing Address |
Po Box 1248 Bloomington IL 61702-1248 |
| Practice Telephone | 7732657670 |
| Practice Fax Number | 7732657674 |
| Mailing Telephone | 3096647930 |
| Mailing Fax Number | 3096647931 |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2018-08-18 |
| Authorized Official Name | MR. ERIC ROHDE (OWNER) |
| Authorized Official Telephone | 3096647930 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | 203.001082 | IL | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | LICENSE | 203.001082 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922264159 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 2301 W 1st St, Ste 5, Ankeny, IA 50023-2470 | 2008-08-07 |
| 1376743922 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 8005 Main St Ste 17, Dexter, MI 48130-1027 | 2007-07-23 |
| 1942389127 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 650 N Girls School Rd Ste C35, Indianapolis, IN 46214-3660 | 2006-11-06 |
| 1275847725 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 414 W Moreland Blvd, Suite 108, Waukesha, WI 53188-2441 | 2010-07-27 |
| 1669795415 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 25835 Narbonne Ave, Suite 280d, Lomita, CA 90717-3074 | 2010-03-09 |
| 1134442361 | Medsource LLC | Durable Medical Equipment & Medical Supplies | 8600 W 95th St, Suite 100a, Overland Park, KS 66212 | 2010-03-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | MEDSOURCE LLC | 3002 Gill St, Bloomington, IL 61704 |
| Virginia Business Entities | MEDSOURCE LLC | 152 Ridings Cove, Williamsburg, Virginia 23185 |
| Street Address |
700 N SACRAMENTO BLVD STE 120 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114058849 | Richard Alan Shapiro | Family Medicine | 700 N Sacramento Blvd, Ste 201, Chicago, IL 60612 | 2007-03-07 |
| 1013395789 | Amy E Board | Social Worker | 700 N Sacramento Blvd, Suite 201, Chicago, IL 60612-1046 | 2015-05-13 |
| 1649605213 | Ventzislava Sotirova | Social Worker | 700 N Sacramento Blvd, Suite 201, Chicago, IL 60612-1046 | 2013-09-13 |
| 1780953984 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 700 N Sacramento Blvd, Ste 130, Chicago, IL 60612-1046 | 2011-12-19 |
| 1972802692 | Kristine Gonyon | Counselor | 700 N Sacramento Blvd, Suite 220, Chicago, IL 60612-1046 | 2011-03-21 |
| 1225364078 | Little City Foundation | Community/Behavioral Health | 700 N Sacramento Blvd, Chicago, IL 60612-1046 | 2009-10-29 |
| 1316180888 | Rhiannon C Reaves | Counselor | 700 N Sacramento Blvd, Suite 220, Chicago, IL 60612-1046 | 2009-04-14 |
| 1316106883 | Erin Elizabeth Atkinson | Social Worker | 700 N Sacramento Blvd, Suite 220, Chicago, IL 60612-1046 | 2008-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415514 | Brandon M Hudson | Durable Medical Equipment & Medical Supplies | 185 N Franklin St Fl 3, Chicago, IL 60606-1932 | 2020-10-26 |
| 1295348084 | Windy City Rehab Specialists LLC | Durable Medical Equipment & Medical Supplies | 1530 S State St Ste C003, Chicago, IL 60605-2964 | 2020-08-31 |
| 1972116499 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 4631 W Foster Ave, Chicago, IL 60630 | 2020-08-25 |
| 1558974071 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 555 W Webster Ave, Chicago, IL 60614-7610 | 2020-08-25 |
| 1689286759 | Tia Strong | Durable Medical Equipment & Medical Supplies | 9413 S Vernon Ave, Chicago, IL 60619-7407 | 2020-08-20 |
| 1174134977 | Home Health Connector, LLC | Durable Medical Equipment & Medical Supplies | 1514 W 87th St Ste 2, Chicago, IL 60620-4819 | 2020-08-14 |
| 1013527092 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 433 W Van Buren St Ste 150, Chicago, IL 60607-0433 | 2020-08-05 |
| 1508475732 | Lakepointe Spine, Inc. | Durable Medical Equipment & Medical Supplies | 3452 N Damen Ave, Chicago, IL 60618-6106 | 2020-07-23 |
| 1578184370 | Tulsa Medical Supply & Logistics Inc | Durable Medical Equipment & Medical Supplies | 1657 S Troy St Apt 1, Chicago, IL 60623-2332 | 2020-05-03 |
| 1063031177 | Nicholas Achtien | Durable Medical Equipment & Medical Supplies | 833 N Clark St Unit 1804, Chicago, IL 60610-3419 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.