Provider Demographics
NPI:1770065765
Name:INR MEDICAL SERVICES LLC
Entity type:Organization
Organization Name:INR MEDICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HAIDEE
Authorized Official - Middle Name:MAURA
Authorized Official - Last Name:POLGAR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:331-725-1352
Mailing Address - Street 1:1755 PARK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8404
Mailing Address - Country:US
Mailing Address - Phone:331-725-1352
Mailing Address - Fax:
Practice Address - Street 1:1755 PARK ST STE 200
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8404
Practice Address - Country:US
Practice Address - Phone:331-725-1352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209016112363LG0600X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty