Healthcare Provider Details

I. General information

NPI: 1699686543
Provider Name (Legal Business Name): MDS ILLINOIS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 KENNEDY DR
EAST MOLINE IL
61244-4203
US

IV. Provider business mailing address

4770 WHITE PLAINS RD
BRONX NY
10470-1136
US

V. Phone/Fax

Practice location:
  • Phone: 646-289-5357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEF SCHENKER
Title or Position: CEO
Credential:
Phone: 718-344-0755