Provider Demographics
NPI:1720277668
Name:D C MEDICAL SUPPLIES COMPANY
Entity Type:Organization
Organization Name:D C MEDICAL SUPPLIES COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:LAMONT
Authorized Official - Last Name:CHAFFIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:312-733-9441
Mailing Address - Street 1:2440 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-2160
Mailing Address - Country:US
Mailing Address - Phone:312-733-9441
Mailing Address - Fax:312-733-9442
Practice Address - Street 1:2440 W MADISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2160
Practice Address - Country:US
Practice Address - Phone:312-733-9441
Practice Address - Fax:312-733-9442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6027750001OtherNATIONAL GOVERNMENT SERVICES
IL6027750001OtherNATIONAL GOVERNMENT SERVICES
IL6027750001OtherNATIONAL GOVERNMENT SERVICES