Provider Demographics
NPI:1720462591
Name:MIDWEST ACCESS SERVICES LLC
Entity Type:Organization
Organization Name:MIDWEST ACCESS SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTOINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMAHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-388-2079
Mailing Address - Street 1:3 W HAWTHORN PKWY STE 410
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1450
Mailing Address - Country:US
Mailing Address - Phone:847-388-2079
Mailing Address - Fax:877-546-7448
Practice Address - Street 1:7335 YANKEE RD STE 101
Practice Address - Street 2:
Practice Address - City:LIBERTY TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45044-0008
Practice Address - Country:US
Practice Address - Phone:513-779-8111
Practice Address - Fax:513-779-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-12
Last Update Date:2015-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH201417800655OtherARTICLE OF ORGANIZATION