Provider Demographics
NPI:1922275668
Name:MY CHOICE MEDICAL
Entity Type:Organization
Organization Name:MY CHOICE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALZATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-882-2134
Mailing Address - Street 1:4514 W WRIGHTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1922
Mailing Address - Country:US
Mailing Address - Phone:773-882-2134
Mailing Address - Fax:773-385-5398
Practice Address - Street 1:4514 W WRIGHTWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1922
Practice Address - Country:US
Practice Address - Phone:773-882-2134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2015-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies