Healthcare Provider Details

I. General information

NPI: 1952099145
Provider Name (Legal Business Name): THEUS MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2023
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2736 VILLAGE GREEN DR APT A1
AURORA IL
60504-5205
US

IV. Provider business mailing address

2736 VILLAGE GREEN DR APT A1
AURORA IL
60504-5205
US

V. Phone/Fax

Practice location:
  • Phone: 630-631-6160
  • Fax:
Mailing address:
  • Phone: 630-631-6160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY THEUS
Title or Position: OWNER
Credential: NURSE PRACTITIONER
Phone: 630-631-6160