Provider Demographics
NPI:1891036232
Name:ILLINOIS HOSPITAL CARE SC
Entity Type:Organization
Organization Name:ILLINOIS HOSPITAL CARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHNAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:IMRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-704-2559
Mailing Address - Street 1:1555 BARRINGTON RD
Mailing Address - Street 2:DOCTORS OFFICE BUILDING #1 SUITE 205
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-1019
Mailing Address - Country:US
Mailing Address - Phone:847-704-2559
Mailing Address - Fax:224-653-9088
Practice Address - Street 1:1555 BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-1019
Practice Address - Country:US
Practice Address - Phone:847-843-2000
Practice Address - Fax:224-653-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty