| American Hospital Service Corporation | |
|
6157 W Belmont Ave Chicago IL 60634-4004 | |
| (773) 745-8434 | |
| (773) 745-3443 |
| Full Name | American Hospital Service Corporation |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 6157 W Belmont Ave, Chicago, Illinois |
| Authorized Official Name and Position | Henryk J Roztoczynski (PRESIDENT) |
| Authorized Official Contact | 7737458434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| American Hospital Service Corporation 6157 W Belmont Ave Chicago IL 60634-4004 Ph: (773) 745-8434 | American Hospital Service Corporation 6157 W Belmont Ave Chicago IL 60634-4004 Ph: (773) 745-8434 |
| NPI Number | 1710296603 |
|---|---|
| Provider Enumeration Date | 09/27/2010 |
| Last Update Date | 10/21/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710296603 | NPI | - | NPPES |
| 036058369 | Medicaid | IL | |
| AR8609236 | Other | IL | FDA |
| 31600059 | Other | IL | BCBS |
| 14D0878232 | Other | IL | CLIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036058369 (Illinois) | Primary |
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