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NPI Code Detail

MEDICARE: GERIATRIC PROFESSIONAL SERVICES SC

MEDICARE: GERIATRIC PROFESSIONAL SERVICES SC
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
1207R00000XInternal Medicine Physician036102125IL

General Provider Information

NPI Number : 1811266315
Entity Type Code : Organization
Provider Name (Legal Business Name) : GERIATRIC PROFESSIONAL SERVICES SC
Provider Business Mailing Address
First Line : 1755 PARK ST STE 200
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8404
Country : US
Telephone Number : 800-353-4980
Fax Number : 800-356-2390
Provider Business Practice Location Address
First Line : 1755 PARK ST STE 200
Second Line :
City : NAPERVILLE
State : IL
Zip : 60563-8404
Country : US
Telephone Number : 800-353-4980
Fax Number : 800-356-2390
Authorized Official
Title or Position : PRESIDENT
Name : KARIM TOURK
Credential : MD
Telephone Number : 815-671-2303
Provider Enumeration Date : 12/29/2011
Last Update Date : 07/07/2025

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Directions to “GERIATRIC PROFESSIONAL SERVICES SC ” Practice Location

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