Provider Demographics
NPI:1467611764
Name:US SERVICES
Entity Type:Organization
Organization Name:US SERVICES
Other - Org Name:US DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HUSSAIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GHALIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-775-1670
Mailing Address - Street 1:6259 W HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-1846
Mailing Address - Country:US
Mailing Address - Phone:773-775-1670
Mailing Address - Fax:773-775-1682
Practice Address - Street 1:6259 W HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1846
Practice Address - Country:US
Practice Address - Phone:773-775-1670
Practice Address - Fax:773-775-1682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2012-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDC5948OtherRAILROAD MEDICARE
IL01635044OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
IL01635044OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
IL01635044OtherBLUE CROSS BLUE SHIELD OF ILLINOIS