Healthcare Provider Details
I. General information
NPI: 1790607018
Provider Name (Legal Business Name): SJ MEDICAL & CLINIC SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
544 LAKEVIEW PKWY STE 100
VERNON HILLS IL
60061-1888
US
IV. Provider business mailing address
544 LAKEVIEW PKWY STE 100
VERNON HILLS IL
60061-1888
US
V. Phone/Fax
- Phone: 346-771-1189
- Fax:
- Phone: 346-771-1189
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SAJJAD ALI
MUHAMMAD
Title or Position: CLAINC
Credential:
Phone: 34-677-1118