MEDICARE: HS CLINICAL SERVICES

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician
2	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
3	171M00000X	Case Manager/Care Coordinator	AL

General Provider Information

NPI Number	:	1194108449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HS CLINICAL SERVICES

Provider Business Mailing Address
First Line	:	1340 S DAMEN AVE
Second Line	:	SUITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60608-1169
Country	:	US
Telephone Number	:	708-292-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 CHASE CORPORATE DR
Second Line	:	SUITE 300
City	:	HOOVER
State	:	AL
Zip	:	35244-1016
Country	:	US
Telephone Number	:	773-292-4800
Fax Number	:

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DIRK O WALES
Credential	:	M.D.
Telephone Number	:	615-564-3511

Provider Enumeration Date	:	07/06/2015
Last Update Date	:	06/05/2019

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Directions to “HS CLINICAL SERVICES ” Practice Location

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