Healthcare Provider Details

I. General information

NPI: 1255367843
Provider Name (Legal Business Name): LIFEWATCH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10255 W HIGGINS RD SUITE 100
ROSEMONT IL
60018-5606
US

IV. Provider business mailing address

10255 W HIGGINS RD SUITE 100
ROSEMONT IL
60018-5606
US

V. Phone/Fax

Practice location:
  • Phone: 847-720-2100
  • Fax: 847-720-2111
Mailing address:
  • Phone: 847-720-2100
  • Fax: 847-720-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number06-607
License Number StateIL

VIII. Authorized Official

Name: THOMAS MCNAMARA
Title or Position: VICE PRESIDENT
Credential:
Phone: 610-729-0504