Provider Demographics
NPI:1912366295
Name:OAK PARK MEDICAL SERVICES PC
Entity Type:Organization
Organization Name:OAK PARK MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:708-733-0364
Mailing Address - Street 1:917 S OAK PARK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1950
Mailing Address - Country:US
Mailing Address - Phone:708-386-3080
Mailing Address - Fax:708-386-3084
Practice Address - Street 1:917 S OAK PARK AVE STE B
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-1950
Practice Address - Country:US
Practice Address - Phone:708-386-3080
Practice Address - Fax:708-386-3084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-16
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty