Healthcare Provider Details

I. General information

NPI: 1720501265
Provider Name (Legal Business Name): IL TMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2017
Last Update Date: 07/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 WAUKEGAN RD STE 209213
GLENVIEW IL
60025-2100
US

IV. Provider business mailing address

7444 LONG AVE
SKOKIE IL
60077-3214
US

V. Phone/Fax

Practice location:
  • Phone: 630-803-8506
  • Fax:
Mailing address:
  • Phone: 847-329-4100
  • Fax: 847-329-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WARREN HOWARD HANDELMAN
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 201-470-5749