Provider Demographics
NPI:1720045859
Name:METRO MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:METRO MEDICAL SERVICES INC
Other - Org Name:STUART D BROWN
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:815-877-7277
Mailing Address - Street 1:5112 FOREST HILLS CT
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111
Mailing Address - Country:US
Mailing Address - Phone:815-877-7277
Mailing Address - Fax:815-877-7281
Practice Address - Street 1:5112 FOREST HILLS CT
Practice Address - Street 2:
Practice Address - City:LOVES PARK
Practice Address - State:IL
Practice Address - Zip Code:61111
Practice Address - Country:US
Practice Address - Phone:815-877-7277
Practice Address - Fax:815-877-7281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-01
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL11041341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA791590880OtherRAILROAD MEDICARE
IL=========001Medicaid
IL206110Medicare ID - Type Unspecified