Provider Demographics
NPI:1851500854
Name:J I L MEDICAL CONSULTANCY LTD
Entity Type:Organization
Organization Name:J I L MEDICAL CONSULTANCY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TADE
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKERE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:773-776-8800
Mailing Address - Street 1:5500 S DAMEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60636-1107
Mailing Address - Country:US
Mailing Address - Phone:773-776-8800
Mailing Address - Fax:773-776-8801
Practice Address - Street 1:6307 S STEWART AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-3116
Practice Address - Country:US
Practice Address - Phone:773-776-8800
Practice Address - Fax:773-776-8801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094343261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094343Medicaid
IL036094343Medicaid
ILG85073Medicare UPIN