Provider Demographics
NPI:1639123482
Name:INTEGRATED UNIVERSAL HEALTH CARE
Entity Type:Organization
Organization Name:INTEGRATED UNIVERSAL HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MUBARAK
Authorized Official - Middle Name:A
Authorized Official - Last Name:MIRJAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-906-2853
Mailing Address - Street 1:12021 S HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1139
Mailing Address - Country:US
Mailing Address - Phone:708-671-2696
Mailing Address - Fax:708-761-3175
Practice Address - Street 1:12021 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1139
Practice Address - Country:US
Practice Address - Phone:708-671-2696
Practice Address - Fax:708-761-3175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL200732Medicare ID - Type Unspecified