Healthcare Provider Details

I. General information

NPI: 1730840687
Provider Name (Legal Business Name): APOLLO MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2022
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4652 OAKTON ST
SKOKIE IL
60076-3145
US

IV. Provider business mailing address

4652 OAKTON ST
SKOKIE IL
60076-3145
US

V. Phone/Fax

Practice location:
  • Phone: 773-852-7866
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ANSAR A MOHAMMED
Title or Position: PRESIDENT
Credential:
Phone: 773-852-7866