Provider Demographics
NPI:1417220617
Name:MARSTECH HEALTHCARE SERVICES, S.C.
Entity Type:Organization
Organization Name:MARSTECH HEALTHCARE SERVICES, S.C.
Other - Org Name:MARSTECH HEALTHCARE SERVICES, S. C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GAJJELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-497-6700
Mailing Address - Street 1:850 W JACKSON BLVD
Mailing Address - Street 2:SUITE # 650
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3032
Mailing Address - Country:US
Mailing Address - Phone:312-497-6700
Mailing Address - Fax:630-910-4294
Practice Address - Street 1:850 W JACKSON BLVD
Practice Address - Street 2:SUITE # 650
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3032
Practice Address - Country:US
Practice Address - Phone:312-497-6700
Practice Address - Fax:630-910-4294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty