MEDICARE: PHYSICIAN CARE SERVICES S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1891891966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIAN CARE SERVICES S.C.

Provider Business Mailing Address
First Line	:	8051 186TH ST
Second Line	:	SUITE A
City	:	TINLEY PARK
State	:	IL
Zip	:	60477-9341
Country	:	US
Telephone Number	:	708-342-7076
Fax Number	:	708-342-7083

Provider Business Practice Location Address
First Line	:	2404 E 79TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60649-5112
Country	:	US
Telephone Number	:	708-342-7076
Fax Number	:	708-342-7083

Authorized Official
Title or Position	:	SECRETARY OF CORPORATION
Name	:	DR. NALINI H THAKRAR
Credential	:	MD
Telephone Number	:	708-342-7076

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	08/22/2020

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