Provider Demographics
NPI:1205043676
Name:APK MEDICAL SUPPLY PROVIDER
Entity Type:Organization
Organization Name:APK MEDICAL SUPPLY PROVIDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-520-8240
Mailing Address - Street 1:251 N MILWAUKEE
Mailing Address - Street 2:SUITE 1004-1006
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089
Mailing Address - Country:US
Mailing Address - Phone:847-520-8240
Mailing Address - Fax:
Practice Address - Street 1:251 N MILWAUKEE
Practice Address - Street 2:SUITE 1004-1006
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089
Practice Address - Country:US
Practice Address - Phone:847-520-8240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5565540001Medicare ID - Type Unspecified