MEDICARE: PAHCS II

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	261QX0100X	Occupational Medicine Clinic/Center

General Provider Information

NPI Number	:	1215921952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAHCS II

Provider Business Mailing Address
First Line	:	245 S GARY AVE
Second Line	:	STE 101
City	:	BLOOMINGDALE
State	:	IL
Zip	:	60108-2228
Country	:	US
Telephone Number	:	630-894-8404
Fax Number	:	630-894-8028

Provider Business Practice Location Address
First Line	:	245 S GARY AVE
Second Line	:	STE 101
City	:	BLOOMINGDALE
State	:	IL
Zip	:	60108-2228
Country	:	US
Telephone Number	:	630-894-8404
Fax Number	:	630-894-8028

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE SUPERVISOR
Name	:	MISS MINDY E YEP SR.
Credential	:
Telephone Number	:	630-539-5275

Provider Enumeration Date	:	09/08/2005
Last Update Date	:	08/22/2020

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Directions to “PAHCS II ” Practice Location

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