Provider Demographics
NPI:1003086794
Name:AMBULATORY HEALTH CARE SERVICES, LTD
Entity type:Organization
Organization Name:AMBULATORY HEALTH CARE SERVICES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARANAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-470-5450
Mailing Address - Street 1:7660 GROSS POINT RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2613
Mailing Address - Country:US
Mailing Address - Phone:847-470-5450
Mailing Address - Fax:847-470-5485
Practice Address - Street 1:7660 GROSS POINT RD
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2613
Practice Address - Country:US
Practice Address - Phone:847-470-5450
Practice Address - Fax:847-470-5485
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBULATORY HEALTH CARE SERVICES, LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1300390332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5027OtherBCBS
IL5027OtherBCBS
IL=========002Medicaid