Healthcare Provider Details

I. General information

NPI: 1770065765
Provider Name (Legal Business Name): INR MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 PARK ST STE 200
NAPERVILLE IL
60563-8404
US

IV. Provider business mailing address

1755 PARK ST STE 200
NAPERVILLE IL
60563-8404
US

V. Phone/Fax

Practice location:
  • Phone: 331-725-1352
  • Fax:
Mailing address:
  • Phone: 331-725-1352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number209016112
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209016112
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number209016112
License Number StateIL

VIII. Authorized Official

Name: HAIDEE MAURA POLGAR
Title or Position: OWNER
Credential: NP
Phone: 331-725-1352