Provider Demographics
NPI:1700812294
Name:MEDICAL OUTSOURCING SERVICES LLC
Entity Type:Organization
Organization Name:MEDICAL OUTSOURCING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-585-9023
Mailing Address - Street 1:1315 MACOM DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-9358
Mailing Address - Country:US
Mailing Address - Phone:877-585-9023
Mailing Address - Fax:630-585-9323
Practice Address - Street 1:1315 MACOM DR
Practice Address - Street 2:SUITE 103
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-9358
Practice Address - Country:US
Practice Address - Phone:877-585-9023
Practice Address - Fax:630-585-9323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE45122284261QR0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0208XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile