Provider Demographics
NPI:1831339373
Name:INTEGRATED ANCILLARY SERVICES
Entity type:Organization
Organization Name:INTEGRATED ANCILLARY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-309-2950
Mailing Address - Street 1:729 PRAIRIE AVE
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-4540
Mailing Address - Country:US
Mailing Address - Phone:847-309-2950
Mailing Address - Fax:
Practice Address - Street 1:750 FLETCHER DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4703
Practice Address - Country:US
Practice Address - Phone:847-888-0663
Practice Address - Fax:847-888-2967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-24
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy