Provider Demographics
NPI:1609849827
Name:UNITED MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:UNITED MEDICAL SERVICES INC
Other - Org Name:UNITED MEDICAL DIAGNOSTIC GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DMITREY
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:STEBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-581-9911
Mailing Address - Street 1:5301 DEMPSTER ST
Mailing Address - Street 2:STE 201
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1846
Mailing Address - Country:US
Mailing Address - Phone:847-581-9911
Mailing Address - Fax:847-581-9922
Practice Address - Street 1:5301 DEMPSTER ST
Practice Address - Street 2:STE 201
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1846
Practice Address - Country:US
Practice Address - Phone:847-581-9911
Practice Address - Fax:847-581-9922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-08
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========0011Medicaid
IL208943Medicare ID - Type Unspecified
IL=========0011Medicaid