Healthcare Provider Details

I. General information

NPI: 1164469581
Provider Name (Legal Business Name): PHYSICIANS MEDICAL SERVICES, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 10/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7531 S STONY ISLAND AVE
CHICAGO IL
60649
US

IV. Provider business mailing address

2158 45TH ST # 519
HIGHLAND IN
46322-3742
US

V. Phone/Fax

Practice location:
  • Phone: 855-276-5212
  • Fax: 888-668-6550
Mailing address:
  • Phone: 855-276-5212
  • Fax: 888-668-6550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ABDULHAMID S KESWANI
Title or Position: PHYSICIAN OWNER
Credential: M.D.
Phone: 855-276-5212