Healthcare Provider Details

I. General information

NPI: 1497952048
Provider Name (Legal Business Name): SPECIALTY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

479 E BUSINESS CENTER DR SUITE 108
MOUNT PROSPECT IL
60056-6037
US

IV. Provider business mailing address

479 E BUSINESS CENTER DR SUITE 108
MOUNT PROSPECT IL
60056-6037
US

V. Phone/Fax

Practice location:
  • Phone: 847-390-8939
  • Fax: 847-390-8937
Mailing address:
  • Phone: 847-390-8939
  • Fax: 847-390-8937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL D. HOFFMAN
Title or Position: OWNER
Credential: COF
Phone: 847-390-8939