Provider Demographics
NPI:1740558840
Name:INSURANCE PHYS SVCS, INC
Entity Type:Organization
Organization Name:INSURANCE PHYS SVCS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/EXAMINER
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIANO
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTROLIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPME-711885
Authorized Official - Phone:630-295-9630
Mailing Address - Street 1:208 RINGNECK, CT
Mailing Address - Street 2:IPS, INC.
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-295-9630
Mailing Address - Fax:630-295-9631
Practice Address - Street 1:208 RINGNECK, CT
Practice Address - Street 2:IPS, INC.
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-295-9630
Practice Address - Fax:630-295-9631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL711885246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty