MEDICARE: MEDICAL OUTSOURCING SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0208X	Mobile Radiology Clinic/Center	IL-0226691-1	IL

General Provider Information

NPI Number	:	1033367248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL OUTSOURCING SERVICES, LLC

Provider Business Mailing Address
First Line	:	100 BAYVIEW CIR
Second Line	:	SUITE 400
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-2983
Country	:	US
Telephone Number	:	800-544-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	15477 COLLECTION CENTER DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60693-0001
Country	:	US
Telephone Number	:	800-544-3215
Fax Number	:

Authorized Official
Title or Position	:	EXEC VP & CFO
Name	:	RHONDA LONGMORE GRUND
Credential	:
Telephone Number	:	800-544-3215

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	10/19/2016

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