Healthcare Provider Details

I. General information

NPI: 1215982491
Provider Name (Legal Business Name): MIDWEST URGENT MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 W RAWSON AVE SUITE 113
OAK CREEK WI
53154-8422
US

IV. Provider business mailing address

4555 W SCHROEDER DR SUITE 170
MILWAUKEE WI
53223-1475
US

V. Phone/Fax

Practice location:
  • Phone: 414-431-6900
  • Fax: 414-435-0016
Mailing address:
  • Phone: 414-365-3210
  • Fax: 414-365-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARIF G JAKA
Title or Position: PARTNER/PHYSICIAN MD/DIRECTOR
Credential: MD
Phone: 414-431-6900