Provider Demographics
NPI:1033866421
Name:MEDYSSEY USA INC
Entity Type:Organization
Organization Name:MEDYSSEY USA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG SU
Authorized Official - Middle Name:
Authorized Official - Last Name:JANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-427-0200
Mailing Address - Street 1:1302 BUSCH PKWY
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4505
Mailing Address - Country:US
Mailing Address - Phone:847-427-0200
Mailing Address - Fax:
Practice Address - Street 1:1302 BUSCH PKWY
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-4505
Practice Address - Country:US
Practice Address - Phone:847-427-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory