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General NPI Number Information
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NPI Number | 1346586096
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Entity Type | Organization
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Legal Business Name | HOSPITAL SERVICES GROUP LLC
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Dates
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Enumeration Date | 12/28/2012
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Last Update Date | 07/22/2022
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Provider Practice Location Address
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Address Line | 326 W 64TH ST 3RD FLOOR
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City | CHICAGO
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State | IL
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Zip | 60621-3114
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Country | US
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Telephone | 630-596-7654
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Fax |
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Provider Business Mailing Address
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Address Line | 326 W 64TH ST 3RD FLOOR
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City | CHICAGO
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State | IL
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Zip | 60621-3114
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | DR. DANTE PIMENTEL
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Credential |
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Telephone | 630-596-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036111599
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License Number State | IL
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