Provider Demographics
NPI:1740229145
Name:VN MEDICAL SUPPLY,INC
Entity type:Organization
Organization Name:VN MEDICAL SUPPLY,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-506-2560
Mailing Address - Street 1:4409 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5605
Mailing Address - Country:US
Mailing Address - Phone:773-506-2560
Mailing Address - Fax:773-506-2656
Practice Address - Street 1:4409 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5605
Practice Address - Country:US
Practice Address - Phone:773-506-2560
Practice Address - Fax:773-506-2656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-05
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL1144230001Medicare ID - Type Unspecified