Healthcare Provider Details

I. General information

NPI: 1265024194
Provider Name (Legal Business Name): ONSITE HEALTH SPECIALTY PHYSICIANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 N LINCOLN AVE STE 180
LINCOLNWOOD IL
60712-1736
US

IV. Provider business mailing address

3926 W TOUHY AVE STE 372
LINCOLNWOOD IL
60712-1028
US

V. Phone/Fax

Practice location:
  • Phone: 847-810-9095
  • Fax:
Mailing address:
  • Phone: 224-766-7669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LIELA MAATOUK
Title or Position: CEO
Credential: MBA
Phone: 847-730-7098