Provider Demographics
NPI:1033203856
Name:MEDLINE HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:MEDLINE HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-643-4042
Mailing Address - Street 1:PO BOX 74673
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-4673
Mailing Address - Country:US
Mailing Address - Phone:312-444-5517
Mailing Address - Fax:612-630-0717
Practice Address - Street 1:1 MEDLINE PL
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4485
Practice Address - Country:US
Practice Address - Phone:847-643-4042
Practice Address - Fax:847-949-2000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies