Provider Demographics
NPI:1649672353
Name:MEDICAL SERVICES SA INC
Entity type:Organization
Organization Name:MEDICAL SERVICES SA INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGES
Authorized Official - Middle Name:B
Authorized Official - Last Name:GERMAIN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:773-375-8188
Mailing Address - Street 1:1135 E 87TH ST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-7011
Mailing Address - Country:US
Mailing Address - Phone:773-375-8188
Mailing Address - Fax:773-375-8188
Practice Address - Street 1:6307 S STEWART AVE STE 304
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:844-431-0411
Practice Address - Fax:844-431-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036046138Medicaid
IL036046138Medicaid