Provider Demographics
NPI:1255367843
Name:LIFEWATCH SERVICES, INC
Entity type:Organization
Organization Name:LIFEWATCH SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-729-0504
Mailing Address - Street 1:10255 W HIGGINS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-5606
Mailing Address - Country:US
Mailing Address - Phone:847-720-2100
Mailing Address - Fax:847-720-2111
Practice Address - Street 1:10255 W HIGGINS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-5606
Practice Address - Country:US
Practice Address - Phone:847-720-2100
Practice Address - Fax:847-720-2111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL06-607293D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00961144OtherRAILROAD MEDICARE
ILP00722416OtherRAILROAD MEDICARE
PAP00394422OtherRAILROAD MEDICARE
PA110233Medicare PIN
CAP00961144OtherRAILROAD MEDICARE
IL215459Medicare PIN