Provider Demographics
NPI:1639285414
Name:ATS MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:ATS MEDICAL SERVICES, LLC
Other - Org Name:PRIORITY ONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMIN OFFICER/CHIEF COMP
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-992-1263
Mailing Address - Street 1:PO BOX 771803
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1803
Mailing Address - Country:US
Mailing Address - Phone:815-963-6885
Mailing Address - Fax:815-639-9521
Practice Address - Street 1:1752 WINDSOR LAKE PARKWAY
Practice Address - Street 2:SUITE 108
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111-4276
Practice Address - Country:US
Practice Address - Phone:317-542-1111
Practice Address - Fax:707-703-4619
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PT-1 HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-22
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
IL125213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL212092OtherMEDICARE
IN720345OtherANTHEM BLUE CROSS
INM300047776OtherMEDICARE ID-TYPE UNSPECIFIED
IN201024140 AMedicaid
IL=========Medicaid
IN201024140 AMedicaid