Provider Demographics
NPI:1750633061
Name:CENTRAL MEDICAL SPECIALISTS, LLC
Entity Type:Organization
Organization Name:CENTRAL MEDICAL SPECIALISTS, LLC
Other - Org Name:CENTRAL MEDICAL SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING AND COLLECTIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:OKEEFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-326-6100
Mailing Address - Street 1:2715 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1351
Mailing Address - Country:US
Mailing Address - Phone:312-326-6100
Mailing Address - Fax:773-385-6890
Practice Address - Street 1:2715 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1351
Practice Address - Country:US
Practice Address - Phone:312-326-6100
Practice Address - Fax:773-385-6890
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL MEDICAL SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-10
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical