MEDICARE: PHYSICIANS REVENUE GROUP

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	246Y00000X	Health Information Specialist/Technologist

General Provider Information

NPI Number	:	1588517635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS REVENUE GROUP

Provider Business Mailing Address
First Line	:	3250 LACEY RD STE 160
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-8344
Country	:	US
Telephone Number	:	630-709-6961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 LACEY RD STE 160
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60515-8344
Country	:	US
Telephone Number	:	630-709-6961
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. MANSOOR AHMED
Credential	:
Telephone Number	:	630-709-6961

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	03/16/2026

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