Provider Demographics
NPI:1972744027
Name:MIDWEST SLEEP MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:MIDWEST SLEEP MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:WASEEM
Authorized Official - Last Name:KAGZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-855-9700
Mailing Address - Street 1:6440 GRAND AVE
Mailing Address - Street 2:203
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-855-9700
Mailing Address - Fax:
Practice Address - Street 1:6440 GRAND AVE
Practice Address - Street 2:203
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5257
Practice Address - Country:US
Practice Address - Phone:847-855-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091991332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG37407Medicare UPIN