Provider Demographics
NPI:1578909933
Name:MIDWEST HEALTHCARE SERVICES, S.C.
Entity Type:Organization
Organization Name:MIDWEST HEALTHCARE SERVICES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:FINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:312-502-1010
Mailing Address - Street 1:4567 W. FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-368-3463
Mailing Address - Fax:312-502-1205
Practice Address - Street 1:4567 W. FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-368-3463
Practice Address - Fax:312-502-1205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization