Healthcare Provider Details

I. General information

NPI: 1649183989
Provider Name (Legal Business Name): IAS MEDICAL EQUIPMENT SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2637 W DEVON AVE
CHICAGO IL
60659-1812
US

IV. Provider business mailing address

2637 W DEVON AVE
CHICAGO IL
60659-1812
US

V. Phone/Fax

Practice location:
  • Phone: 817-254-3828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: AYUB V TALATI
Title or Position: MANAGER
Credential:
Phone: 817-254-3828