Provider Demographics
NPI:1376728105
Name:PMI SERVICES, LLC
Entity Type:Organization
Organization Name:PMI SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PREDEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-885-2100
Mailing Address - Street 1:34 SAWGRASS DR
Mailing Address - Street 2:
Mailing Address - City:LEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60439-7738
Mailing Address - Country:US
Mailing Address - Phone:630-885-2100
Mailing Address - Fax:630-257-1343
Practice Address - Street 1:34 SAWGRASS DR
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-7738
Practice Address - Country:US
Practice Address - Phone:630-885-2100
Practice Address - Fax:630-257-1343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1417934639OtherNPI
ILE18298Medicare UPIN