Healthcare Provider Details

I. General information

NPI: 1255543344
Provider Name (Legal Business Name): MEDCO PHYSICIANS UNLIMITED INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15520 ROSE DR
SOUTH HOLLAND IL
60473-1337
US

IV. Provider business mailing address

16260 LOUIS AVE UNIT 1546
SOUTH HOLLAND IL
60473-5285
US

V. Phone/Fax

Practice location:
  • Phone: 708-432-8445
  • Fax:
Mailing address:
  • Phone: 708-724-7570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. ANWAR YAMINI SR.
Title or Position: PRESIDENT
Credential:
Phone: 708-432-8445