MEDICARE: TFM 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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	336.075460	IL

General Provider Information

NPI Number	:	1174927016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TFM SERVICES, LLC

Provider Business Mailing Address
First Line	:	1175 ANDERSON DR
Second Line	:
City	:	GREEN OAKS
State	:	IL
Zip	:	60048
Country	:	US
Telephone Number	:	847-302-8176
Fax Number	:

Provider Business Practice Location Address
First Line	:	27885 IRMA LEE CIR STE 105
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-5129
Country	:	US
Telephone Number	:	847-302-8176
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS F MIENTUS
Credential	:
Telephone Number	:	847-302-8176

Provider Enumeration Date	:	10/21/2014
Last Update Date	:	10/21/2014

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