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General NPI Number Information
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NPI Number | 1831339373
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Entity Type | Organization
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Legal Business Name | INTEGRATED ANCILLARY SERVICES
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Dates
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Enumeration Date | 02/24/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 750 FLETCHER DR SUITE 105
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City | ELGIN
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State | IL
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Zip | 60123-4703
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Country | US
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Telephone | 847-888-0663
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Fax | 847-888-2967
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Provider Business Mailing Address
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Address Line | 729 PRAIRIE AVE
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City | BARRINGTON
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State | IL
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Zip | 60010-4540
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Country | US
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Telephone | 847-309-2950
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. EDWARD HERSHMAN
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Credential |
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Telephone | 847-309-2950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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