Provider Demographics
NPI:1740585579
Name:ONSITE HEALTHCARE, INC., SC
Entity Type:Organization
Organization Name:ONSITE HEALTHCARE, INC., SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ISSAM
Authorized Official - Middle Name:M
Authorized Official - Last Name:MAATOUK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-810-9095
Mailing Address - Street 1:7301 N LINCOLN AVE
Mailing Address - Street 2:SUITE #183
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1709
Mailing Address - Country:US
Mailing Address - Phone:847-810-9095
Mailing Address - Fax:
Practice Address - Street 1:7301 N LINCOLN AVE
Practice Address - Street 2:SUITE #183
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-1709
Practice Address - Country:US
Practice Address - Phone:847-810-9095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086819207R00000X
IN01041801A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty